Direct Deposit Authorization Form

Employees and contractors who elect payroll direct deposit complete this form to authorize [Company] to deposit payment into the bank account they designate. The authorization remains in effect until the signer provides written notice of cancellation or change of bank account information.

The Direct Deposit Authorization form on the right captures the signer’s identifying information, organization name and Tax ID when applicable, the bank name and account holder name, the account and routing numbers, and the account type (checking or savings). The signer attests that the account information is accurate, agrees to promptly notify payroll of any changes, and releases [Company] from liability for errors or delays in the deposit process when [Company] has acted in good faith and exercised reasonable care.

The signed form is filed in the employee or contractor’s HR / payroll record. Provide an updated form whenever banking information changes.