Direct Deposit Form

Direct Deposit

Checking and or Savings
Employee Name
I hereby authorize: Toddlers To Grandparents, LLC, to initiate credit entries and to initiate necessary debit entries and adjustments for any credit entries in error to my (our) account (s) listed below.
Name of bank savings loan or credit union
Routing/Transit Number
Account Number
Is this account Checking or a Savings account?

CheckingSavings
Percent of Net Amount to be Deposited (example 100%)
Fixed Dollar Amount to be Deposited (example $50.00)
Option for Second Account
Name of bank savings loan or credit union
Routing and Transit Number
Account Number
Is this Checking or Savings account?

CheckingSavings
Percent of Net Amount to be Deposited (example 100%)
Fixed Dollar Amount to be Deposited (example $50.00)
This form along with a Voided Check (NO Deposit Tickets Please) or Bank Direct Deposit Account Spec Sheet, for each account, is to be kept on file with the employer for up to 2 years after termination of this agreement.
Please upload a VOIDED check or a COPY of a Voided Check from each account listed above.

Cancelof
This authority is to remain in full force and effect until termination of employment.
EMPLOYEE SIGNATURE

Clear
DATE

MonthDayYear
Should be Empty:

Direct Deposit