Nurses Direct - Authorization For Direct Deposit
This authorizes NURSES DIRECT, LLC to send credit entries (and appropriate debit and adjustment entries), electronically or by any other commercially accepted method, to my (our) account(s) indicated below 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.
Bank Account Type (choose one)
Name of Bank
Bank Routing #
Bank Account #
This authorization will be in effect until NURSES DIRECT, LLC recieves a written termination notice from myself and has a reasonable opportunity to act on it.
Employee Authorization Signature
Employee Phone Number
Submit to Payroll
Should be Empty: