Direct Deposit

Name*

First NameLast Name

Email*

Your paycheck details (stub) will be emailed to the address shown above.

Your Name as it appears on your Bank Account:*

Name of your Bank:*

Bank Account Number:*

Bank Routing Numbers (this will be a 9 digit number):*

Type of Account*

CheckingSavings

I authorize The Fudgery to initiate entries to the account indicated below as follows:

1. They may initiate CREDIT entires, which moves money into my account according to the schedule and other conidtions to which The Fudgery and I have agreed.

2. They my initiate DEBIT entries to reverse any transactions they have originated to my account in error.

This authority is to remain in effect until The Fudgery has received written notification of its termination and has reasonable opportunity to act upon it.

Date

MonthDayYear

Signature*

Your Direct Deposit will not go into effect until we have also received either a Voided Check or a Document from the Financial Institution that includes your routing and account number (a deposit slip is NOT an acceptable document for this purpose). Sometimes your banking app will give you this information and you can submit a screenshot of the information.

Upload a picture or file from your bank showing your routing and account number.*

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