DIY Legal Forms

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Direct Deposit Authorization

Name:

Tax Identification Number:

As a matter of convenience to our employees, the [Company] can direct deposit either a portion of or your entire payroll to the financial institution of your choice.

[ ] Please Direct Deposit my entire net payroll check to:

Name of Bank and Branch:

Account Number:

Routing Number:

I, [Name] (full name) do hereby request the deposit of my entire net payroll check into the above named bank account each pay period. I further authorise [Name] and [Name] to withdraw any funds deposited in error into my account.

[ ] Please deposit a portion of my payroll through a Direct Payroll Deduction to:

I hereby request and authorise the sum of [$------] to be deducted from my paycheck each pay period, and to be deposited directly into the bank account named above. I further authorise [Name] and _[Name] to withdraw any funds deposited in error into my account.

[ ] I would like to cancel my deposit authorisation. I hereby cancel the previously submitted authorisation for direct deposit and/or payroll deduction deposit.

Dated:

Signature

Name of Employee

A copy of deposit slip is attached.