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INSTRUCTIONS: ARIZONA ELECTRONIC PAYMENT AUTHORIZATION (Form CSE-1129A)

To authorize the Arizona State Disbursement Unit to supervise payment of child or spousal support through electronic direct deposit, a form CSE-1129A should be completed by the person making payment. This document can be obtained from the website maintained by the Arizona Department of Economic Security.

Arizona Electronic Payment Authorization CSE-1129A Step 1: Check the first box if filing a new direct deposit authorization.

Arizona Electronic Payment Authorization CSE-1129A Step 2: Check the second box if filing for a new electronic payment card.

Arizona Electronic Payment Authorization CSE-1129A Step 3: Check the third box if filing to stop EPC and start direct deposits.

Arizona Electronic Payment Authorization CSE-1129A Step 4: Check the fourth box if filing to stop direct deposits and start EPC.

Arizona Electronic Payment Authorization CSE-1129A Step 5: Check the fifth box if you are filing this form only to make changes to bank account information already on file.

Arizona Electronic Payment Authorization CSE-1129A Step 6: If you receive or have received cash assistance in the past, and/or have applied for IV-D assistance, or if you have received assistance from the Department of Child Support Enforcement, check the box next to "IV-D" and enter your ATLAS case number.

Arizona Electronic Payment Authorization CSE-1129A Step 7: If none of the statements in Step 6 apply and your case only involves a local court, check the box next to "Non IV-D Case."

Arizona Electronic Payment Authorization CSE-1129A Step 8: Enter the custodial parent's name in the first blank box and your contact phone number in the second blank box.

Arizona Electronic Payment Authorization CSE-1129A Step 9: Enter the custodial parent's date of birth in the third blank box and their Social Security number in the fourth blank box.

Arizona Electronic Payment Authorization CSE-1129A Step 10: Enter the custodial parent's current address in the fifth blank box.

Arizona Electronic Payment Authorization CSE-1129A Step 11: Indicate with a check mark whether filing regarding a checking or savings account.

Arizona Electronic Payment Authorization CSE-1129A Step 12: Give your ABA bank routing number or account number, your financial institution's name, and one or both names (as applicable) on the account.

Arizona Electronic Payment Authorization CSE-1129A Step 13: Print and sign your name and enter the date at the bottom of the form.