Get Aetna Gc-16512 2018-2026

Filling out the Aetna GC-16512 form online for Electronic Fund Transfer (EFT) or Direct Deposit Authorization can streamline your payment process with Aetna. This guide will walk you through each component of the form to ensure accurate and efficient completion.

Follow the steps to accurately complete the Aetna GC-16512 form.

1. Click the ‘Get Form’ button to obtain the form and open it in your preferred editing tool.
2. Enter the enrollee's information, including their last name, first name, and middle initial. Ensure the member ID number is correctly filled out to avoid any processing delays.
3. Provide your current address, including the city, state, and ZIP code. Make sure that the address is complete and accurate for correspondence purposes.
4. Fill in the required contact details, including the email address and telephone number. An email address is mandatory for communication regarding your application.
5. Indicate the bank name where your account is held. This must be a financial institution capable of processing Automated Clearing House (ACH) transactions.
6. Select the type of account you are authorizing for deposits: checking or savings. Ensure you provide the correct routing number (a 9-digit number) and your account number.
7. Write the name on the account exactly as it appears on your bank records to prevent any discrepancies.
8. Select whether this is an initial request, change of information, or termination request according to your situation.
9. For verification purposes, staple a voided check or a savings withdrawal slip to the form. If unavailability of these documents exists, attach a letter from your banking institution indicating the necessary details.
10. Review your entries to confirm accuracy and completeness before signing. The enrollee must add their signature and date the form.
11. Mail your completed form to the specified address: FOREIGN SERVICE BENEFIT PLAN, PO Box 14079, Lexington, KY 40512-4079. Alternatively, you can fax it to (959) 282-1516.

Complete your Aetna GC-16512 form online today to ensure seamless processing of your Electronic Fund Transfer.