Direct Deposit Form | Free PDF | Word

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The templates below are a very important tool for Human Resources when an employee prefers to have his or her payroll deposited directly into their personal bank account instead of receiving a payroll paper check.

The direct deposit authorization form from your Human Resources Department must be signed by any employees requesting automatic deposit of paychecks and retained on file by the employer.

The Direct Deposit Agreement Form #1 below includes:

Direct Deposit Authorization Form / Agreement

As the account holder, I hereby authorize [Company Name] to initiate automatic deposits to my account at the financial institution named below. I also authorize [Company Name] to make withdrawals from this account in the event that a credit entry is made in error. Further, I agree not to hold [Company Name] responsible for any delay or loss of funds due to incorrect or incomplete information supplied by me or by my financial institution or due to an error on the part of my financial institution in depositing funds to my account. This agreement/authorization will remain in effect until [Company Name] receives a written notice of cancellation from me or my financial institution, or until I submit a new form for direct deposit to the Payroll Department.

  • Account Information – Name of financial institution, routing number, account number, and type of account (checking account or savings account).
  • Authorized Signatures with Dates – Verify that the employee signed the completed form and agree to the terms of the form.
  • Space for Voided Check or Deposit Slip – Include instructions for employee to attach a voided check or deposit slip. These items will contain the address, city, state, and zip code of the account holder.

After the employee fills out the form then there is a statement to remind them to return the form to the Payroll Department.

Direct Deposit Benefits

There are many benefits to the employee if he or she decides to do direct deposit such as:

  • No more rushing to the bank or financial institution for money before they close to complete a deposit slip and deposit the payroll check.
  • Enjoying the benefits of payroll direct.
  • Knowing the paycheck will be already in the bank every pay period on the same payroll date and sometimes earlier depending on if payroll date falls on holidays or weekends.
  • No more worrying about check getting lost in the mail.
  • No more worrying about losing a check.
  • If your employee is out of town, they know their money will be deposited in their account to access with am ATM or bank debit card. Funds will always be in their account when they need them.

Click on the link(s) to download the Direct Deposit Template(s) below:

Generic Direct Deposit Form (PDF / Word)

Sample Direct Deposit FormETF Authorization (PDF / Word)

Sample ETF Authorization Form