Note: If funds are to be deposited into only one account, you MUST select the ALL box. If a PERCENTAGE or DOLLAR AMOUNT is entered, you MUST provide the secondary account information below for the remaining balance.
Direct Deposit Authorization
SC Public Employee Benefit Authority
South Carolina Retirement Systems
202 Arbor Lake Drive, Columbia, SC 29223
Phone Number with Area Code
THE LANGUAGE USED IN THIS DOCUMENT DOES NOT CREATE ANY CONTRACTUAL RIGHTS OR ENTITLEMENTS AND DOES NOT CREATE A CONTRACT BETWEEN THE MEMBER AND THE SOUTH CAROLINA PUBLIC EMPLOYEE BENEFIT AUTHORITY. THE SOUTH CAROLINA PUBLIC EMPLOYEE BENEFIT AUTHORITY RESERVES THE RIGHT TO REVISE THE CONTENT OF THIS DOCUMENT.
1. Primary Account Information:
Check appropriate system:
The amount specified below will be directly deposited into this account.
Financial Institution Name
OR You may enter a percentage or dollar amount:
Financial Institution Name
(OR mark with "X" with two witnesses OR Power of Attorney, if on file with the Retirement Systems)
(Note: This form must be signed and dated. See notes on Page 2.)
2. Secondary Account Information: The remaining balance will be directly deposited into this account.
Form 7204
Revised 10/11/2024
Sign in blue or black ink
TAPE A VOIDED CHECK HERE (No deposit slips or starter checks, please)
TAPE A VOIDED CHECK HERE (No deposit slips or starter checks, please)
Attach a voided check, current bank statement or signed letter from your bank that includes your name, account number and routing number. Do not attach a starter check or deposit slip. Remember to complete all required fields and sign the form before returning it.
Attach a voided check, current bank statement or signed letter from your bank that includes your name, account number and routing number. Do not attach a starter check or deposit slip. Remember to complete all required fields and sign the form before returning it.