PD F 5512 Bank Change Request

RESET
For official use only:
Customer Name

Customer No.

PD F 5512 E
Department of the Treasury
Bureau of the Public Debt
(Revised May 2010)

OMB No. 1535-0138

TreasuryDirect®

BANK CHANGE REQUEST

www.treasurydirect.gov
304-480-7711

IMPORTANT: Follow instructions in filling out this form. You should be aware that the making of any false, fictitious, or
fraudulent claim or statement to the United States is a crime that is punishable by fine and/or imprisonment.

Use this form to add (or edit) bank information in your TreasuryDirect account.
1. TREASURYDIRECT ACCOUNT INFORMATION
TreasuryDirect Account Number:
TreasuryDirect Account Name:

Taxpayer Identification Number (SSN/EIN):
Please apply this information to all of my TreasuryDirect accounts.
Please apply this information to the TreasuryDirect accounts listed below:
(Account Numbers of Other Primary Accounts or
Custom, Conversion, or Minor Linked Accounts to
Which the Bank Information Should be Added)

2. ADD (EDIT) BANK INFORMATION Provide the bank account you want added to your TreasuryDirect account(s). If you want to
edit any bank account information already listed in your TreasuryDirect account(s), such as correcting an account or routing number,
complete all of the following fields as if you were adding a new bank account. We will add all of the information as a new bank account.
You can then access your TreasuryDirect account and delete the unwanted bank account.

Please add the following bank information to my TreasuryDirect account:
Bank Name:
Routing Number:
Account Number:
Name(s) on Account:
Account Type:

Checking

Savings

Make this my Primary Bank information for purchases and payments.
Complete the following if you want to add another bank to your TreasuryDirect account:
Bank Name:
Routing Number:
Account Number:
Name(s) on Account:
Account Type:

Checking

Savings

You will receive an e-mail once we have added the bank account(s) to your TreasuryDirect account.
PD F 5512 E
Page 1 of 4

KEEP PAGE 4 OF THIS FORM FOR REFERENCE
It contains instructions for
• deleting an unwanted bank account
• changing the source of funds on pending purchases
• changing the payment destination for interest and/or maturity payments
3. SIGNATURES AND CERTIFICATIONS
Under penalties of perjury, I certify that the information provided on this form is true, correct, and complete. I certify that I have
the authority to authorize financial transactions using the bank information described on this form. This request is submitted
pursuant to the applicable provisions of 31 CFR Parts 353, 356, 357, 360, and 363. I agree to indemnify and hold the
United States harmless in the event of any loss that results from this request.

•

•
•

You must wait until you are in the presence of a certifying officer to sign this form.
Certifying officers are available at banks, trust companies, and credit unions.
Certification by a notary public is NOT acceptable.

Sign Here:
(Daytime Telephone No.)

(Signature)

(Number and Street or Rural Route, City, State, and ZIP Code)

•

Certifying Officer:

•
•

The individual must sign in your presence and you must complete the certification and affix your
stamp or seal.
Acceptable certifications include the financial institution’s official seal or stamp (such as
corporate seal, signature guaranteed stamp, or medallion stamp).
Certification by a notary public is NOT acceptable.

I CERTIFY that

, whose identity is known or was

(Name of Person Who Appeared)

proven to me, personally appeared before me this

,

day of
(Month)

,
(Year)

, and signed this form.

at
(City)

(State)

(Signature of Certifying Officer)

(OFFICIAL STAMP
OR SEAL)

(Printed Name and Title of Certifying Officer)

(Name of Financial Institution)

(Address)

ACCEPTABLE CERTIFICATIONS: Financial institution's
official seal or stamp (such as corporate seal, signature
guaranteed stamp, or medallion stamp).

(City, State, and ZIP Code)

(Notary certification is NOT acceptable.)
(Phone Number)
PD F 5512 E
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No. 1

INSTRUCTIONS
TREASURYDIRECT ACCOUNT INFORMATION
®

Provide the TreasuryDirect Account Number and the Account Name. If you want the new bank information added to other
TreasuryDirect accounts registered in the same name or to any minor linked accounts for which you are the custodian,
provide the account numbers.
No. 2

ADD (EDIT) BANK INFORMATION

Provide the complete bank information as it should appear. The account must be at a U.S. depository financial institution that
will accept debits and credits using the Automated Clearing House method of payment.
•

Bank Name – Show the name of the financial institution.

•

Routing Number – Show your financial institution's ABA identifying number. This is the routing/transit number that
identifies the institution. You may need to contact the financial institution to obtain this number.

•

Account Number – Show the account number at your financial institution.

•

Name(s) on Account – Show the name or names as it/they appear on the account at your financial institution.

• Account Type – Mark the appropriate box to indicate whether the account is "checking" or "savings."
Mark the box if the bank added is to be your Primary Bank for purchases and payments. A Primary Bank appears first on the
bank information list and in the drop-down boxes throughout TreasuryDirect.
Complete the fields at the bottom of the section to add another bank.
No. 3

SIGNATURES AND CERTIFICATIONS

The applicant must appear before and establish identification to the satisfaction of an authorized certifying officer available at
a bank, trust company, or credit union and sign the application in the officer's presence. The officer must then complete the
certification form provided and imprint the seal or stamp required in certifying requests. For certifications within the
United States, the certifying individual must be authorized to bind his/her institution by his/her acts and guarantee signatures
to assignments of securities or certify assignments of securities. For a list of authorized certifying individuals and the required
evidence of authority, see Title 31 CFR Part 363. Certification by a notary public is NOT acceptable.
If you are a parent of a minor TreasuryDirect account owner, your signature certifies that you are requesting the transaction
on the minor's behalf and for the minor's benefit.

Additional Evidence – The Commissioner of the Public Debt, as designee of the Secretary of the Treasury, reserves the
right, in any particular case, to require the submission of additional evidence.

Where to Send – Send the form, as well as any other forms and evidence, to:
DEPARTMENT OF THE TREASURY
BUREAU OF THE PUBLIC DEBT
PO BOX 7015
PARKERSBURG, WV 26106-7015
PRIVACY ACT AND PAPERWORK REDUCTION ACT NOTICE
The collection of the information you are requested to provide on this form is authorized by 31 U.S.C. CH. 31 relating to the public debt of the United States. The
furnishing of a social security number, if requested, is also required by Section 6109 of the Internal Revenue Code (26 U.S.C. 6109).
The purpose of requesting the information is to enable the Bureau of the Public Debt and its agents to issue securities, process transactions, make payments, identify
owners and their accounts, and provide reports to the Internal Revenue Service. Furnishing the information is voluntary; however, without the information Public Debt
may be unable to process transactions.
Information concerning securities holdings and transactions is considered confidential under Treasury regulations (31 CFR, Part 323) and the Privacy Act. This
information may be disclosed to a law enforcement agency for investigation purposes; courts and counsel for litigation purposes; others entitled to distribution or
payment; agents and contractors to administer the public debt; agencies or entities for debt collection or to obtain current addresses for payment; agencies through
approved computer matches; Congressional offices in response to an inquiry by the individual to whom the record pertains; as otherwise authorized by law or
regulation.
We estimate it will take you about 02 minutes to complete this form. However, you are not required to provide information requested unless a valid OMB control number is
displayed on the form. Any comments or suggestions regarding this form should be sent to the Bureau of the Public Debt, Forms Management Officer, Parkersburg, WV
26106-1328. DO NOT SEND the completed form to the above address; send to the address shown in "Where to Send" in the instructions.

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INSTRUCTIONS YOU MAY NEED FOLLOWING THE ADDITION OF A BANK ACCOUNT
--KEEP THIS PAGE FOR FUTURE REFERENCE-Adding a bank account to your TreasuryDirect account is only that—the addition of a bank account. It does not delete
any previously entered bank accounts nor does it change the source of funds for pending purchases or the destination
for interest and/or maturity payments. After we add a bank account to your TreasuryDirect account, you may need to do
one or more of the following:
•

Delete a Bank Account – You can access your TreasuryDirect account and delete any bank as long as it is not
the Primary Bank. If you would like us to designate a different bank already listed in your TreasuryDirect
account as your Primary Bank, e-mail us by clicking the Contact Us link in your TreasuryDirect account.

•

Change the Source of Funds for Pending Purchases – You may change the source of funds on pending
purchases by accessing your TreasuryDirect account and deleting the previous bank. The system will then
prompt you to choose a bank from a drop-down list. If you do not wish to delete the previous bank, you can
change the source of funds by deleting the purchases and re-scheduling them using another bank.

•

Change the Payment Destination for Interest & Maturity Payments (Treasury Bills, Notes, Bonds, and
TIPS) – You may change the interest and/or maturity payment destination(s) to a different bank by accessing
your TreasuryDirect account and deleting the previous bank. The system will then prompt you to choose a bank
from a drop-down list. If you do not wish to delete the previous bank, you can change the payment
destination(s) by clicking the Edit Payment Destination button on the Current Holdings Detail page for each
security.

HOW A CLOSED BOOK PERIOD CAN AFFECT YOUR REQUEST
Four business days prior to a scheduled interest and/or maturity payment, TreasuryDirect imposes a Closed Book
Period that locks applicable marketable securities so we can schedule upcoming payments. This rule applies to interest
payments, maturity payments, and reinvestments for bills, notes, bonds, and TIPS.
TreasuryDirect's Closed Book Period starts at 12:00 midnight Eastern Time on the fourth business day prior to the
security's interest payment date and/or final maturity date, and it ends at 12:00 midnight Eastern Time on the interest
payment/maturity date.
TreasuryDirect will not allow the following during the Closed Book Period:
•
•
•
•
•
•

Changes to registration
Changes to the payment destination
Changes to View/Transact Rights
Internal and external transfers
SellDirect requests
Changes to reinvestments

If the security is in a Closed Book Period because of maturity of the security, any online transactions scheduled but not
processed will be cancelled. If the security is simply paying interest, the scheduled transactions will be processed as
soon as the security is out of the Closed Book Period.

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