GPS - Direct Deposit Enrollment Form

DIRECT DEPOSIT ENROLLMENT FORM

GPS Solution Services LLC
EMPLOYEE NAME*

First NameLast Name
E-MAIL ADDRESS*
example@example.com
PHONE NUMBER*
Please enter a valid phone number.
MAILING ADDRESS*

Street Address

Street Address Line 2

CityState

Zip Code
NAME OF BANK*
ACCOUNT NUMBER*
9-DIGIT ROUTING NUMBER*
Type of Account:*

CheckingSavings
Attach a voided check for account to which funds should be deposited.*

Cancelof
GPS Solution Services LLC is hereby authorized to directly deposit my pay to the account listed above. This authorization will remain in effect until I modify or cancel it in writing.
By typing your name below, you understand and agree that this form of electronic signature has the same legal force and effect as a manual signature.
Date

MonthDayYear
Date
Should be Empty:

DIRECT DEPOSIT ENROLLMENT FORM