Free Printable Bank Direct Deposit Form

Here’s a basic direct deposit form that you can use:

[Bank Name]
[Bank Address]
[City, State ZIP Code]
[Bank Phone Number]
[Bank Email]

Direct Deposit Authorization Form

Employee Information:

  • Full Name: [Enter Full Name]
  • Address: [Enter Address]
  • City, State ZIP Code: [Enter City, State ZIP Code]
  • Phone Number: [Enter Phone Number]
  • Email: [Enter Email]
  • Social Security Number: [Enter Social Security Number]
  • Date of Birth: [Enter Date of Birth]

Bank Information:

  • Bank Name: [Enter Bank Name]
  • Bank Routing Number: [Enter Bank Routing Number]
  • Bank Account Number: [Enter Bank Account Number]
  • Account Type: [Enter Account Type, such as Checking or Savings]

Authorization Agreement:

I authorize my employer, [Employer Name], to initiate credit entries to my account at [Bank Name] for the purpose of direct deposit. I understand that I am responsible for verifying that the credit has been made to my account.

I understand that I must notify my employer promptly if there are any changes to my bank account information, including changes to my account number or account type.

I certify that the above information is correct and accurate. By signing below, I authorize [Employer Name] to initiate direct deposit to my bank account.

[Employee Signature]

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