Direct Deposit Authorization Form

Direct Deposit Enrollment Form

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Prepare:
You will need the account # (1-17 digits) and your bank's routing # (9-digits).

Where do I find these numbers?
Please do not mix these numbers u,p or your deposit will not be successful.

Savings Account: Check your online bank information or call your bank.
Check Account: Same as above, or look at your check or deposit slips. The numbers may be in a different order on your checks/deposit slips. Here is an example:
Your Name*

First NameLast Name
Email Address*
Best email to send Direct Deposit Notification
Contact Number*
Please enter a valid phone number.
Name of Bank*
Type of Account:*

CheckingSavings
Account Number*
The unique number your bank assigned to you
9-Digit Routing Number*
Your banks 9-digit routing number used for Direct Deposits.
SIGNATURE: Apply your signatuare as best you can in the box below...*

Clear
Date

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Date
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Direct Deposit Enrollment Form