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Injured workers receiving disability benefits, excluding death and temporary partial, are eligible for direct deposit and should use this form to apply for it. Please complete the enrollment form inside this brochure and return it in the enclosed envelope.The OSC has the right to retract and correct payments, as necessary. What you get: Instant access to fillable Microsoft Word or PDF forms. If you live in the United States and certain U.S. Territories, you can enroll in direct deposit through myPay. Please complete this form in order for us to complete your enrollment process and begin depositing your funds electronically. Please complete this form in order for us to complete your enrollment process and begin depositing your funds electronically. Please read and sign before completing and submitting. You must complete a separate form for each type of federal payment (social security, supplemental income, veterans benefits, etc.). Institution before any Medicare direct deposits are made.