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Direct Deposit

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0% found this document useful (0 votes)

46 views1 page

Direct Deposit

Uploaded by

Copyright

© © All Rights Reserved

We take content rights seriously. If you suspect this is your content, claim it here.

Available Formats

Download as PDF, TXT or read online on Scribd

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Authorization for Direct Deposit

I authorize to deposit my pay automatically to the

account(s) indicated below and, if necessary, to adjust or reverse a deposit for any payroll entry
made to my account in error. This authorization will remain in effect until I cancel it in writing and
in such time as to afford
a reasonable opportunity to act on it.

Name on bank account:

Name of bank:

Bank account number: Checking or Savings

Bank routing number:

Amount: $ or entire paycheck

Balance of pay to:

Manual (paper) check

Account described below

Name on bank account:

Name of bank:

Bank account number: Checking or Savings

Bank routing number:

Important: Please attach a voided check for each bank account to which funds should be
deposited.

Employee/Contractor signature:

Date:

Payers: Do not send this form with your Direct Deposit enrollment. Keep for your
records.

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