Authorization for Direct Deposit (6/19)

• Contact the Local Government Services Bureau at lgs@wisconsin.gov to request this form
• Note: As a local government, in Section 4 of this form, you must select "Yes" to indicate you receive payments from DOR's State and Local Finance Division
• Mail completed forms to:
  Wisconsin Department of Revenue
  Local Government Services Bureau
  MS 6-97, PO Box 8971
  Madison, WI 53708-8971