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Direct Deposit Form Instructions

This direct deposit form allows the user to choose how their paycheck will be deposited each pay period by selecting either the entire paycheck amount, a fixed dollar amount, or a percentage of the paycheck. The user provides their name, account type (checking), routing/ABA number, deposit account number, bank information, and signs and dates the form to authorize their employer to deposit their paycheck into the specified account each pay period.

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Rogers Kevinn
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144 views1 page

Direct Deposit Form Instructions

This direct deposit form allows the user to choose how their paycheck will be deposited each pay period by selecting either the entire paycheck amount, a fixed dollar amount, or a percentage of the paycheck. The user provides their name, account type (checking), routing/ABA number, deposit account number, bank information, and signs and dates the form to authorize their employer to deposit their paycheck into the specified account each pay period.

Uploaded by

Rogers Kevinn
Copyright
© All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
  • Direct Deposit Form

DIRECT DEPOSIT FORM

Print this form


Choose your deposit amount (per pay period) and sign the voided check
Give your completed form to your Employer, Government Agency, or Benefits Provider

Choose Deposit Amount


Select One Only

Entire Paycheck (100% of each paycheck)

Fixed amount: $________ (example: $150 from each paycheck)

Percent of Paycheck: _______ (example: 50% of each paycheck)

Account Information
Name CRISTINA L SCHAFER
Account Type Checking
Routing / ABA Number 031101169
Deposit Account Number 163102448053
Bank The Bancorp Bank
Address Attn: Deposit Operations, P.O. Box 15329,
Wilmington, Delaware, United States, 19885.

Customer Service 855-403-8344

Pay to the order of __________ VOID _____________________________________ $ VOID

I authorize my employer/payer to deposit my check directly into my smiONE Florida Visa Prepaid Card account each
period as indicated. If an incorrect amount should be entered into my account, I authorize my bank to make the appropriate
adjustments.

___________________________ ________
Cardholder Signature Date
Routing Number Account Number
031101169 163102448053

DIRECT DEPOSIT FORM Choose Deposit Amount Select One Only Entire Paycheck (100% of each paycheck) Fixed amount: $________

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