ABS Billing
One Tower Square Hartford, CT 06183 1-888-616-8715
DIRECT DEPOSIT / ELECTRONIC FUNDS TRANSFER (EFT)
OF MONTHLY COMMISSIONS AND OTHER COMPENSATION
FOR BUSINESS AND PERSONAL INSURANCE
All direct bill commissions and all other forms of agency compensation, including fixed, value-based commission and contingent commission will be deposited directly to your bank account via electronic funds transfer.
Complete the form below and fax it, along with a voided check from the account into which you would like deposits made.
Fax to: 1-877-896-0804 or (860) 954-6331
Authorization for Direct Deposit of Monthly Commission and Other Compensation
Agency Name: _______________________________________ |
Agency Telephone No: ________________________ |
Agency E-mail address:________________________________ |
Agency Contact Name: _______________________ |
Producer code (s) ________________________________________________
Bank Name: ____________________________ City, State, Zip: _______________________________
Bank Transit/Routing No. _____________________________ Bank Account No. _______________________________
Checking (___) Savings (___)
I hereby authorize Travelers to deposit my monthly commissions / compensation into my account at the bank designated above. I understand sending written notification to my local Travelers representative can revoke this authorization.
Depositor Signature: ________________________________________________ |
Date:_______________ |
Please attach VOIDED CHECK here or to a separate page.
EFT Form (Rev.09/07)