Goodwill of Colorado Direct Deposit Form
Direct Deposit of paychecks is a benefit offered to all employees at any time. Once this form is received in
Payroll, it will be pre-noted on the next payday and an actual deposit will occur on the following payday. (Pre-
note means that the information is sent to your financial institution to make sure the account information is
correct.) Forms are due into the Payroll Dept. by the Friday prior to each payday. IF YOU ATTACH A VOIDED
CHECK OR LETTER FROM THE BANK YOU CAN BYPASS THE PRE-NOTE.
You may split your direct deposit between two accounts, even if they are at different financial institutions. Please
note that all “checks” will be split in the manner you choose (i.e., a separate bonus “check” will be split). If you
want all funds in only one account, please only complete the “First Deposit” section. If you are splitting your
funds, please indicate the dollar amount in the “First Deposit” section – the balance will automatically go to the
account indicated in the “Second Deposit” section.
If you do not enroll when you in-process, you may do so at any time afterwards.
AUTHORIZATION AGREEMENT FOR DIRECT DEPOSIT
[ ] New [ ] Change [ ] Stop
I hereby authorize Goodwill of Colorado (or any of its subsidiaries or sister companies) to initiate direct
deposits from my biweekly earnings as follows:
Please Print Clearly First Deposit Second Deposit
[ ] Full or [ ] Partial $
[ ] checking or [ ] savings [ ] checking or [ ] savings
DEPOSITORY (Bank) NAME:
CITY, STATE:
ACCOUNT NO.:
TRANSIT/ABA NO.:
PLEASE ATTACH A VOIDED CHECK or BANK FORM (Not a Deposit Slip)
FROM EACH APPLICABLE ACCOUNT.
This authorization is to remain in full force and effect until the Company has received written
notification from me of its termination in such a manner that the Company will receive it ten (10)
business days prior to the next scheduled transaction.
I also understand that failure to submit my time card by the scheduled due time will result in my direct
deposit transaction not being processed for that pay period.
(Print) NAME: Employee No.
SIGNATURE: Date:
FOR PAYROLL USE ONLY
Date received in PR: Date entered :
/conversion/tmp/activity_task_scratch/892145931.doc last modified: 4/25/12
Goodwill of Colorado Direct Deposit Form
FOR PAYROLL USE ONLY
Date received in PR: Date entered :
/conversion/tmp/activity_task_scratch/892145931.doc last modified: 4/25/12
