"Employee Direct Deposit Enrollment Form - Paragon Payroll & Hr"

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Employee Direct Deposit Enrollment Form
Payroll Manager – Please complete this section before distributing to your employees.
Company Name:_____________________________________________ Date:_________________
Payroll Mgr. Name:_________________________ Payroll Mgr. Signature:____________________
To enroll in Full Service Direct Deposit, 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 of 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. **AGAIN,
PLEASE DO NOT SUBMIT ANYTHING OTHER THAN A VOIDED CHECK OR WE WILL BE
UNABLE TO PROCESS YOUR DIRECT DEPOSIT!! **
Attach a voided check in this space. If this is the only account you are using for direct deposit your
net pay will be deposited in this account. If you distribute to a second account (i.e. savings) fill in the
information below regarding that second account and amount to distribute. Your remaining amount
owed to you will be deposited in this account.
[Attach voided check here]
Second Account Information
If you are distributing to a second account fill in the following information for that account. Please
be sure to indicate the type of account, along with the amount to be deposited.
Bank Name/City/State:______________________________________________________________
Routing/Transit#:
:
Account Number
Checking
Savings
Other:__________________________________________________
I wish to deposit: $________.____
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.
-
-
Employee Name:___________________________ Social Security#:
Employee Signature:_____________________________________ Date:______________________
Employee Direct Deposit Enrollment Form
Payroll Manager – Please complete this section before distributing to your employees.
Company Name:_____________________________________________ Date:_________________
Payroll Mgr. Name:_________________________ Payroll Mgr. Signature:____________________
To enroll in Full Service Direct Deposit, 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 of 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. **AGAIN,
PLEASE DO NOT SUBMIT ANYTHING OTHER THAN A VOIDED CHECK OR WE WILL BE
UNABLE TO PROCESS YOUR DIRECT DEPOSIT!! **
Attach a voided check in this space. If this is the only account you are using for direct deposit your
net pay will be deposited in this account. If you distribute to a second account (i.e. savings) fill in the
information below regarding that second account and amount to distribute. Your remaining amount
owed to you will be deposited in this account.
[Attach voided check here]
Second Account Information
If you are distributing to a second account fill in the following information for that account. Please
be sure to indicate the type of account, along with the amount to be deposited.
Bank Name/City/State:______________________________________________________________
Routing/Transit#:
:
Account Number
Checking
Savings
Other:__________________________________________________
I wish to deposit: $________.____
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.
-
-
Employee Name:___________________________ Social Security#:
Employee Signature:_____________________________________ Date:______________________