ACH Authorization Form

4 BEST BUSINESS CORP
Direct Deposit Agreement Form
Authorization Agreement
I,
hereby authorize 4 BEST BUSINESS CORP to initiate automatic deposits to my account at the financial institution named below. I also authorize 4 BEST BUSINESS CORP to make withdrawals from this account in the event that a credit entry is made in error.
Further, I agree not to hold 4 BEST BUSINESS CORP responsible for any delay or loss of funds due to incorrect or incomplete information supplied by me or by my financial institution or due to an error on the part of my financial institution in depositing funds to my account.
This agreement will remain in effect until 4 BEST BUSINESS CORP receives a written notice of cancellation from me or my financial institution, or until I submit a new direct deposit form to the Payroll Department.
Email
example@example.com
Account Information
Name of Financial Institution:
Routing Number:
Account Number:
Account Number:

CheckingSavings
Authorized Signature:

Clear
Date:

MonthDayYear
Date
Should be Empty:

4 BEST BUSINESS CORP