Send completed form to the following address or fax it to 1-. If faxing, please keep original for your records.Personal Information: Your name, address, phone number and email. •. Time Off: A view of your current time off balances. •. You only need to supply the section which lists your name, address, account number and routing number. Provide First and Last Name. 2. Simply complete the authorization below and attach a. Complete our direct deposit form (click here) and return to HACA as soon as possible.