Direct Deposit

Payroll Direct Deposit Authorization Mast Trucking Inc.

Complete the form below, along with signing and attaching a voided check and return to the Payroll Department.

Checking AccountSavings Account (select one)

Using the information indicated below to the financial institution listed below. I understand that the amount deposited will be the net pay amount from each payday. I understand and acknowledge that origination of ACH transactions to my account must comply with the provisions of the U.S. government.

First Name

Last Name

Last 4 of SSN

Financial Institution Name*

Attach a voided check or enter the Account Number and Routing Number

9 Digit Routing Transit Number

Account Number

100Flat

Flat Amount

% Amount

This direct deposit authorization will remain in effect until Mast Trucking Inc. has received written notification from me of its termination or my employment is terminated. Direct deposit/changes should become available on the second payday after Mast Trucking Inc. receives the completed request.

Employee Signature

Date

Email address for pay stubs

example@example.com

Attach a voided check here: (optional)