Direct Deposit Authorization
Authorize your employer or payer to deposit payments directly into your bank account securely.
Full Name
*
First Name
Last Name
Email Address
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Bank Name
*
Name on the Account
*
Business or Personal Account
*
Business
Personal
Account Type
*
Checking
Savings
Routing Number
*
Account Number
*
Repeat Account Number
*
Authorization Agreement Text
*
This authorizes RTV, Inc. to send credit entries electronically or by any other commercially accepted method, to my (our) account(s) indicated above and to other accounts I (we) identify in the future (the “Account”). This authorizes the financial institution holding the Account to post all such entries. I agree that the ACH transactions authorized herein shall comply with all applicable U.S. Law. This authorization will be in effect until the Company receives a written termination notice from myself and has a reasonable opportunity to act on it.
Signature
*
Submit Authorization
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