Direct Deposit Authorization Form
By completing this form, you consent for [company name] to deposit your wages, minus
applicable taxes, directly into your bank account on a week/bi-weekly/monthly basis. This form
is not valid without the signature of the accountholder.
Name (please print)
Address City State ZIP
Phone Date (MM/DD/YY)
Signature
Banking Information
Account Number: ____________________________
Routing Number: ____________________________
Name of Financial Institution: __________________________________
Address of Financial Institution: ___________________________________
___________________________________
___________________________________
This direct deposit form for new hires created by Betterteam.