Direct Deposit
Pay Method Request Form
Caregiver#
*
Please enter a valid phone number.
Format: 0000000000.
Name
*
First Name
Last Name
Email
*
Notifications are available once we make transfers to your account. - BetterDays
Bank name and routing#
*
Please Select
WELLS FARGO - 121042882
BANK OF AMERICA - 121000358
CHASE - 322271627
US BANK - 121122676
CITIBANK - 321171184
OTHERS
Other Bank Name
If Bank Name is NOT on the list.
Other Bank Routing#
If Bank Routing# is NOT on the list.
Bank account#
*
Account Type
*
Please Select
Checking
Savings
Please submit a voided check
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Account must be in your name
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of
I authorize Better Days In-Homecare Provider deposit payments on my account.
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