Louisville Beauty Academy - Direct Deposit Form
For Employee and Independent Contractor
Today's Date
-
Month
-
Day
Year
Please include the date which this form is being submitted
Employee/Contractor Name
*
(AS IT APPEARS ON YOUR BANK ACCOUNT)
Bank Name and Address
*
Please provide the current Bank Name and Address which you currently use for Direct Deposit
Routing Number
*
Account Number
*
Account Type
*
Checking / Savings Account
Direct Deposit Form
*
Browse Files
Please attach voided check to form.
Cancel
of
Signature of Endorser
*
Please sign for authorization to use direct deposit system to make direct payments into the above listed account.
Submit
Should be Empty: