Authorization of Direct Deposit JC

Employee Authorization of Direct Deposit

The undersigned hereby authorizes JC International to make payroll deposits in the account identified below and authorizes the bank to accept such deposits. It is agreed that these deposits may be made electronically and under the Rules of the Automatic Clearing House (ACH) system. This authorization will remain in effect until written notice of termination is given to the above stated company. I further agree that if my employer's ACH collection is dishonored or if any adjustments or corrections need to be made to my payroll, JC International may reverse or draft any authorized deposit made to any bank account identified below. This form is also my acceptance to receive my pay stubs via an online secure portal. Employee will indemnify and hold JC International harmless from any loss from and against any claim, cause of action, damage, loss, fee, award, costs (including reasonable attorney's fees, court costs, and expert witness fees) penalty. or any other cost, fee, loss, or damage (jointly and severally the "Claims") incurred by JC International as a result of Employees: (i) supplying false or misleading information on this form; (ii) reversing any deposits made, or permitting such deposit to be attached, garnished. or used in such a manner as to cause a Claim to be filed against JC International.

Name*

Please enter first & last.

Email Address*

example@example.com

Street Address*

City*

State*

Zip Code*

Bank Name*

Attach copy of a voided check or bank direct deposit instructions - DEPOSIT SLIPS ARE NOT VALID*

Account Type*

CheckingSavings

Routing #*

Account #*

Authorized Signature*

Date*

Date