Fill in this form, sign it, date it, and return it to: Orange County Clerk of Courts. Fill this form out and turn in to your employer.How to Complete this Form. 1. We recommend that you retain a copy of this form. Please complete the form in its entirety and upload with a voided check or bank letter in your online provider portal. Provide Social Security Number. 4. The purpose of this policy is to provide guidelines for establishing Direct Deposit for cash assistance payments.