Update Direct Deposit Information BACK TO DASHBOARD Loading... There was a problem with your submission. Errors have been highlighted below. To enroll in Full Service Direct Deposit, simply fill out this form and give it to your payroll manager. Attach a voided check for each checking account–not a deposit slip. 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. Below is a sample check MICR line, detailing where the information necessary to complete this form can be found. Important! Please read and sign before completing and submitting. I hereby authorize my employer (hereinafter “Company”) to deposit any amounts owed me by initiating credit entries to my accounts at the financial institutions (hereinafter “Bank”) indicated on this form. Further, I authorize Bank to accept and to credit any credit entries indicated by Company to my accounts. In the event that Company deposits funds erroneously into my account, I authorize Company 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 Company and Bank have received written notice from me of its termination in such time and in such manner as to afford Company and Bank reasonable opportunity to act on it. Would you like to get paid using direct deposit? * Yes No Date * Employee Name * First Last Social Security Number * Employee Signature Bank Account Information * The last item must be for the remaining amount owed to you. To distribute to more accounts, please complete another form. Make sure to indicate what kind of account, along with amount to be deposited if less than your total net paycheck. 1. Bank Name * 1. 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Utah Westminster - Colorado Wichita Falls - Texas Wichita - Kansas Wilmington - North Carolina Winston?Salem - North Carolina Worcester - Massachusetts Yonkers - New York Select your bank account location 1. Account Type * Checking Savings Others 1. Deposit Entire Net Amount? * Yes 1. Routing/Transit: $ * 1. Account Number: * 1. Voided check Please uploaded a voided check image. Click to see example (in a new window) Accepted file types: jpg, gif, png.