Set Up Your Direct Deposit

Employee Information

Name*

First Last

Email

If you do not have an email address, leave blank.

Facility*

Deposit Preferences

Do you want your money deposited to 1 or to 2 bank accounts?

One Account
Two Accounts

Primary Account

Type of Account

Checking
Savings

Routing Number*

Account Number*

Bank Name

Payment Amount*

Full Amount
% of Net Pay
Set Amount of Net Pay

% of Net Pay: A percentage of your check will be deposited into this account. Any remaining pay will either go to a second account below (if elected) or will be paid by paper check.

Set Amount of Net Pay: A flat amount from your check will be deposited into this account. Any remaining pay will either go to a second account below (if elected) or will be paid by paper check

Specify Percentage*

Please enter a value between 1 and 99.

Specify Amount*

Secondary Account

Type of Account

Checking
Savings

Routing Number*

Account Number*

Bank Name

Payment Amount*

Remaining Pay
% of Remaining Pay
Set Amount of Net Pay

% of Net Pay: A percentage of your remaining pay will be deposited into this account. Any remaining pay will be paid by paper check.

Set Amount of Net Pay: A flat amount from your check will be deposited into this account. Any remaining pay will be paid by paper check.

Note:
All remaining pay after the selected percentage will be paid as a paper check. If you wish to have the full amount of the second check direct deposited, select "Remaining Pay" from the choices above.

Specify Percentage*

Please enter a value between 1 and 99.

Specify Amount*

Terms

Agreement*

Yes, I agree

I have chosen Direct Deposit as the method of payment in which I want to receive my paycheck. I authorize , and the financial institution(s) listed below to initiate electronic credit entries and, if necessary, debit entries and adjustments for any credit entries in error to the account(s) listed above or what was on file with previous management each payday. This authority will remain in effect until I cancel it in writing with .

Signature*

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