Tenants and Residents Direct Deposit Authorization
1065 Pinehurst Drive | PO Box 4717 | Rocky Mount, NC 27803
Phone: 252.977.3141
Fax: 252.977.2587
Emergency After-Hours: 252.977.6223
Office Hours: Monday - Friday | 8:30 am - 5:00 pm
If you prefer to print this form, please complete and return to:
Rocky Mount Housing Authority
1065 Pinehurst Drive
PO Box 4717
Rocky Mount, NC 27803
If you wish to complete this form online, please fill out and submit below.
Fields marked with * must be filled out or form will not submit.
Part 1: Transaction Type
Check the Appropriate box(es).
NOTE: The payee must review Part 2 and complete Part 3 for all Transaction Types
NEW SETUP - Select if payee is not currently on direct deposit.
- The payee or financial institution representative must complete Part 4.
CANCELLATION - Select if payee wants to stop direct deposit.
- Do not complete Part 4.
CHANGE FINANCIAL INSTITUTION
- The payee or NEW financial institution representative must complete Part 4.
CHANGE ACCOUNT NUMBER
- The payee or financial institution representative must complete Part 4.
CHANGE ACCOUNT TYPE
- The payee or financial institution representative must complete Part 4.