Direct Deposit Form

Direct Deposit Authorization

Please fill out your information below.
I authorize PayPlus, LLC and the financial institution listed below to deposit as indicated and make adjusting entries as may be required.

This authorization may be cancelled by me at any time.

For Checking Account deposits, please provide a copy of a VOIDED check(s) attached to this form.

For Savings Account deposits, please obtain a verification letter from your bank with account number and Bank routing number. NOTE: Routing numbers are not on deposit slips for savings accounts.

FORMS WILL NOT BE PROCESSED WITHOUT THE REQUIRED DOCUMENTS ABOVE.
Route this form to:
Select your Payroll Specialist. You do not have to enter their email. Form will be emailed automatically to the person selected.
Company & Employee Names*

CompanyEmployee
New Direct DepositChange to existing Direct Deposit
Bank Details
Institution Name*
Account Owner Name*
Account type*
YesNo
Main (deposit funds to this account first)Secondary (deposit remaining amount to this account)
Enter percent of pay OR fixed dollar amount to be deposited in this account.
Percent. Enter 100 for full net pay.
Fixed $ Amount.
Routing Number*
Account Number*
If employee is having pay divided between two bank accounts, submit a second Direct Deposit form for each account.
Attach voided check or bank letter. (Required.)*

See link below for blank copy
Cancelof
Signature

Clear
Date*

MonthDayYear
Date
Please verify that you are human*
Should be Empty:

Direct Deposit Authorization