"Employee Direct Deposit Enrollment Form - Tri-County Arc"

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Tri-County ARC
Employee Direct Deposit Enrollment Form
To enroll in Full Service Direct Deposit, simply fill out this form and return it to the payroll
office. 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 for 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.
The 9-digit routing/transit number is located at the bottom left had side. The account number
is usually in the lower center of the check.
Employee Name: ____________________________ Employee I.D. # _________
Employee Signature: ___________________________ Date: _______________
Account Information:
The last item must be for the remaining amount owed to you.
Make sure to indicate what kind of account, along with the amount to be deposited, if less than
your total net paycheck.
Bank Name: ______________________________________________________
Routing Transit #: ____________________ Account #: ____________________
Checking ___ Savings ___ Other ___
I wish to deposit: $_________ or Entire Net Amount ____
Bank Name: ______________________________________________________
Routing Transit #: ____________________ Account #: ____________________
Checking ___ Savings ___ Other ___
I wish to deposit: $_________ or Entire Net Amount ____
Bank Name: ______________________________________________________
Routing Transit #: ____________________ Account #: ____________________
Checking ___ Savings ___ Other ___
I wish to deposit: $_________ or Entire Net Amount ____
Tri-County ARC
Employee Direct Deposit Enrollment Form
To enroll in Full Service Direct Deposit, simply fill out this form and return it to the payroll
office. 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 for 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.
The 9-digit routing/transit number is located at the bottom left had side. The account number
is usually in the lower center of the check.
Employee Name: ____________________________ Employee I.D. # _________
Employee Signature: ___________________________ Date: _______________
Account Information:
The last item must be for the remaining amount owed to you.
Make sure to indicate what kind of account, along with the amount to be deposited, if less than
your total net paycheck.
Bank Name: ______________________________________________________
Routing Transit #: ____________________ Account #: ____________________
Checking ___ Savings ___ Other ___
I wish to deposit: $_________ or Entire Net Amount ____
Bank Name: ______________________________________________________
Routing Transit #: ____________________ Account #: ____________________
Checking ___ Savings ___ Other ___
I wish to deposit: $_________ or Entire Net Amount ____
Bank Name: ______________________________________________________
Routing Transit #: ____________________ Account #: ____________________
Checking ___ Savings ___ Other ___
I wish to deposit: $_________ or Entire Net Amount ____