Direct Deposit Authorization Form

Collects employee banking details and authorization for payroll direct deposit, including account verification and optional split deposit instructions.

Employee Information

• Employee full name
• Employee ID
• Work email
• Department

Bank Account Details

• Account type
• Bank name
• Routing number
  Enter the 9-digit routing number exactly as it appears on your bank documents.
• Account number
  Enter your account number. Use the number from your bank statement or check, not your debit card number.
• Confirm account number
  Re-enter the same account number to verify accuracy.

Deposit Instructions

• Deposit method
• Split deposit instructions
  Add each deposit destination and specify either a fixed amount or percentage. The total should equal 100% or the full net pay amount, depending on payroll rules.

Verification and Authorization

• I confirm that the banking information provided is accurate and belongs to me, and I authorize payroll deposits to this account.
• Authorization date
• Employee signature
• Consent and privacy notice