DIRECT DEPOSIT ENROLLMENT
Account Information
If depositing to a savings account, ask your bank to give you the Routing/Transit Number for your
account. It isn't always the same as the number on a savings deposit slip. This will help ensure that you
are paid correctly. The last item must be for the remaining amount owed to you. Make sure to indicate
what kind of account, along with amount to be deposited, if less than your total net paycheck.
Bank Name: City/State:
Routing/Transit #: Account #:
Deposit: $ __________ or ✔ Entire Net Amount Checking
Savings
Bank Name: City/State:
Routing/Transit #: Account #:
Deposit: $ __________ or Remaining Net Amount Checking
Savings
Bank Name: City/State:
Routing/Transit #: Account #:
Deposit: $ __________ or Remaining Net Amount Checking
Savings
Authorization
I hereby authorize my employer to deposit any amounts owed me by initiating credit entries to my account
at the financial institution(s) (hereinafter "Bank") indicated on this form. Further, I authorize Bank to accept
and to credit any credit entries indicated by my employer to my account. In the event that my employer
deposits funds erroneously into my account, I authorize my employer to debit my account for an amount
not to exceed the original amount of the erroneous credit.
This authorization is to remain in full force and effect until my employer and Bank have received written
notice from me of its termination in such time and in such manner as to afford my employer and Bank
reasonable opportunity to act on it.
Employee Name: Social Security #:
Signature: Date:
Payroll Manager: Company Name: Titan Security Group
Signature: Date:
