Employer Direct Deposit Form

Direct Deposit Authorization Form

Complete this form to set up direct deposit for payroll. Please provide accurate employer, employee, and banking information to ensure timely payment processing.

Employer Information

Company Name*

Employer EIN*

9-digit Employer Identification Number

Payroll Contact Name*

Payroll Contact Email*

Payroll Contact Phone*

Employee Information

Employee Full Name*

Start Date*

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Employment start date

Employee ID*

Pay Frequency*

Bank Account Details

Bank Name*

Routing Number*

Found at bottom left of check

Account Number*

Found at bottom center of check

Account Type*

Attachments

Voided Check Upload

Choose a photo or drag it here.

Uploading...

Upload a photo or scan of a voided check for verification

Authorization

Employee Signature*

Draw Type Upload

Choose your signature image

Date*

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HR Representative Signature

Draw Type Upload

Choose your signature image

HR Approval Date

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