TEMPORARY DISABILITY / CAREGIVERS INSURANCE, Rhode Island Department of Labor and Training with DLT logo and state seal

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Direct Deposit Authorization Form


The following form authorizes TDI/TCI to directly deposit your benefit payment into a savings or checking account.

Direct Deposit
Authorization Form
    Formulario de autorización
de Depósito Directo

Please print out the form, fill it in, attach check marked "void" or bank documentation of routing and account numbers and mail everything to:

Temporary Disability Insurance
P.O. Box 20100
Cranston, RI 02920

Bank Check showing routing number and account number





























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8/6/19 MDF