Below is the  Direct Deposit Enrollment Formtemplate body. If necessary, please put the personal information, company information, such as text to replace the specific content you need. you can download the .doc template file on the end of the article by click download link. 

ELECTRONIC FUNDS TRANSFER AUTHORIZATION



I hereby authorize my employer to directly deposit my pay in the bank account(s) listed below in the percentages specified. (If two accounts are designated, deposits are to be made in whole percentages of pay to total 100%). I have attached a voided check or deposit slip for each account specified below. This authorization is to remain in force until the company has received written authorization from me of its termination or change.

Also, I grant [COMPANY] the right to correct any Electronic Funds Transfer resulting from an erroneous overpayment by debiting my account to the extent of such overpayment.


Name:




Address:




Telephone:

(    )


Signature:



Date:




Company Use Only:           Effective Date:





Account #1


Checking 


Savings          (Check only one)


Financial Institution: 


Address: 


Telephone:

(    )




Personal Account Number: 



Percent of pay to be deposited into this account:    %



Company Use Only: Bank/ABA Number:




Account #2


Checking 


Savings        (Check only one)


Financial Institution: 


Address: 


Telephone:

(    )




Personal Account Number: 



Percent of pay to be deposited into this account:    %



Company Use Only: Bank/ABA Number: 




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