Please deposit my benefit directly into the account indicated. Information required includes the payee's name, case number, and type of account, alongside the bank's name, routing number, and account number.Complete the Authorization Agreement for Automatic Bank Deposit form on the back of this letter. For Direct Deposit please attach a voided check or savings account statement showing your account number. How to fill out the Direct Deposit Authorization Form - County of Los Angeles? 1. Gather all necessary documents including a voided check or bank verification. Complete the attached form and mail it to LACERA. Include all requested information about your financial institution and where you want your money deposited. Com) or fax (213) 628-7716. BEGIN Direct Deposit: Please deposit my retirement allowance directly in the account indicated below.