14397 E Geronimo Rd, Scottsdale, AZ 85259
Employee Direct Deposit Authorization
Employee: Fill out and return to your employer.
Employer: Save for yout files only.
This document must be signed by employees requesting automatic deposit of paychecks and retained on file by the employer. Employees must attach a voided check for each of their accounts to help verify their account numbers and bank routing numbers.
Account 1 type: CheckingSavings
Bank routing number (ABA number):
Dollar amount to be deposited to this account:
Account 2 (remainder to be deposited to this account):
Account 2 type:CheckingSavings
Attach a voided check for each account here
Authorization (enter your company name in the blank space below)
This autorizes (the "Company") to send credit entries (and appropriate debit and adjustment entries), electronically or by any other commercially accepted method, to my (our) account(s) indicated below and to other accounts I (we) identify in the future (the "Account). This authorizes the financial institution holding the Account to post all such entries. agree that the ACH transactions authorized herein shall comply with all applicable U.S. Law. This authorization wiii be in effect until the Company receives a written termination notice from myself and has a reasonable opportunity to act on it.,
Employee ID #:
Date September 22, 2023
Leave this empty:
Your legal name
Your email address
If you have questions about the contents of this document, you can email the document owner.
Document Name: Payroll form
Agree & Sign