Direct Deposit Authorization
Complete this form for each company you want to
set up with direct deposit.
Send this direct deposit authorization form to the company* that’s making the direct deposit for you. For payroll
direct deposit, please give this form to the human resources department. If you have Social Security or other
governmental direct deposit, please go to any Fifth Third Financial Center, and a banker can get you started.
Last Name First Name
Street Address City State Zip
Work Phone Home Phone
Social Security Number
Employer’s Name Phone Number Employee ID Number or Department
Account #1:
Fifth Third Account Number Routing and Transit Number
Checking Account Savings Account Amount of Direct Deposit
$
Account #2:
Fifth Third Account Number Te Routing and Transit Number
Checking Account Savings Account Amount of Direct Deposit
$
Check only one:
A New Authorization for Direct Deposit. Please Change my Existing Authorization.
Not Currently Using Direct Deposit. Transfer Automatic Payment from my Previous
Bank to Fifth Third Bank.
Employee Signature Date
Employer Signature Date
(cont.)
Fifth Third and Fifth Third Bank are registered service marks
of Fifth Third Bancorp. Fifth Third Bank, National Association.
June 2020 Member FDIC. Equal Housing Lender. 1
Direct Deposit Information
To set up direct deposit with your employer you will need to refer to the
information provided below. Please print or download this document.
Account Type:
1001
VOID
Date
Pay to
Memo
1001
Routing Number Account Number
LIDN
Fifth Third Bank, National Association. Member FDIC. Equal Housing Lender. Fifth Third and Fifth Third Bank are
registered service marks of Fifth Third Bancorp.