The Generic Direct Deposit Authorization Form is a document that allows individuals to authorize their employer or another entity to deposit funds directly into their bank account. This form is essential for ensuring timely and secure payments, whether for payroll or other financial transactions. By completing this form, individuals can streamline their banking processes and avoid the hassle of paper checks.
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DIRECT DEPOSIT AUTHORIZATION FORM
Fill in the boxes below and sign the form.
Last NameFirst NameM I
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Social Security Number
□□□- □□ - □□□□
Action
□ □
Effective Date
□New
□□ □□ □□
ChangeCancel
M onthDayYear
Work Phone
□□□-□□□-□□□□
Name of Financial Institution
□□□□□□□□□□□□□□□□□□□□□□□□□□
Account Number
(Include hyphens but omit spaces and special symbols.)
Type of Account
Savings
Checking
□□□□□□□□□□□□□□□□□
□
Routing Transit Number
□□□□□□□□□
(All 9 boxes must be filled. The first two numbers
Ownership of Account
must be 01 through 12 or 21 through 32.)
Self
Joint
Other
By signing this agreement, I authorize ____________________ to initiate credit entries to the account indicated above for the purpose of expense and/or payroll.
I also authorize ______________________________ to initiate, if necessary, debit entries and adjustments for any credit entries made in error.
Signature ____________________________________________________________________________________ Date ___________________
If the account is a joint account or in someone else's name, that individual must also agree to the terms stated above by signing below.
HOW TO COM PLETE THIS FORM
1.Fill in all boxes above.
2.Sign and date the form.
TIP
Call your financial institution to
JOHN PUBLIC
1234
make sure they will accept direct
0 deposit s.
123 MAIN STREET
19
YOUR TOWN, FL 12345
Verify your account number and
PAY TO THE
routing transit number with your
ORDER OF
0 financial institution
$
YOUR TOWN BANK
DOLLARS
Do not use a deposit slip to verify
0 the routing
number.
FOR
IRouting Transit Number
I
➤
Account
l~::::::::,(~::250000005::)•:(~:=1234556789022~):..1·___________ J
Number
NOTE: THE ACCOUNT AND ROUTING NUM BER M AY APPEAR IN DIFFERENT PLACES ON YOUR CHECK.
When setting up direct deposit, several other forms and documents may be required to ensure a smooth process. Each of these documents serves a specific purpose and helps facilitate the necessary transactions and verifications. Below is a list of commonly used forms alongside the Generic Direct Deposit form.
Completing these forms accurately is crucial for ensuring that the direct deposit process is efficient and without complications. It is recommended to double-check all information before submission to avoid any delays in payroll processing.