DIRECT DEPOSIT AUTHORIZATION FORM
Company Name: TTEC
Employee Name: ______________________________
Employee ID: ______________________________
Department: ______________________________
Employee Information
Full Name: ______________________________________
Address: ________________________________________
City/State/Zip: _________________________________
Phone Number: _________________________________
Email Address: _________________________________
Banking Information
Bank Name: ____________________________________
Bank Address: _________________________________
Account Type: ■ Checking ■ Savings
Account Number: ______________________________
Routing Number: ______________________________
Deposit Details
■ Full Deposit – Deposit entire paycheck
■ Partial Deposit – Deposit $________
Authorization Agreement
I authorize TTEC to deposit my wages into the account listed above.
Signature
Signature: ______________________________
Date: ______________________________