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Get Louisiana Child Support Direct Deposit

TDD: 225-922-8111 OR FAX: 225-248-0487 (Cancellation of Direct Deposit Only) AUTHORIZATON FORM: Direct Deposit Please Type or Legibly PRINT all information below in ink. Section 1: CUSTODIAL PARENT INFORMATION Name: LASES Case Number Mailing Address: City/State/ZIP: Daytime Telephone: Home Telephone: Social Security Number: Email: Section 2: FINANCIAL INSTITUTION INFORMATION Name of Financial Institution: City/State/ZIP: Telephone: Routing Number: Account Type (Check One): Check O.

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