Employee Direct Deposit Authorization

Employee Direct Deposit Authorization
Checking (attached voided check)Savings (attach deposit slip and obtain ABA routing number from your bank)
Financial Institution*
$ (A Dollar Amount)% (A Percentage)
Enter the dollar amount or the percentage.*
Personal Account Number:*
ABA (Routing Number) *
Checking (attached voided check)Savings (attach deposit slip and obtain ABA routing number from your bank)
Financial Institution
$ (A Dollar Amount)% (A Percentage)
Enter the dollar amount or the percentage.
Personal Account Number:
ABA (Routing Number)
I hereby authorize Buckeye Residential Solutions to directly deposit my pay in the bank account(s) listed below in the percentages specified. (If two accounts are designated, deposits are to be made in whole percentages of pay to total 100%.) I have attached a voided personalized check (checking accounts) or deposit slip (savings accounts) for each account specified below. No more than two accounts may be designated. This authorization is to remain in force until the Company has received written authorization from me of its termination or change. Also, I hereby grant Buckeye Residential Solutions the right to correct any such electronic funds transfer resulting from an erroneous overpayment by debiting my account to the extent of such overpayment.
Name*

First NameLast Name
Email*
example@example.com
Signature*

Clear
Date*

MonthDayYear
Should be Empty: