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Get Lifespan Direct Deposit Form

LifeSpan Direct Deposit of Payroll Checks Authorization Agreement I hereby authorize LifeSpan to initiate a Direct Deposit to my account and the Bank named below Check one Checking Account Savings Account You may divide your deposit between different accounts. If you choose to do this indicate the dollar amounts to be deposited into each account. Amounts will be deposited for each payroll period every two weeks. Checking Account Amount Savings Account Amount Your name as listed on the Account Your Address as listed on the Account City State Zip Code FOR A CHECKING ACCOUNT The bank transit number and the account number are listed on your checks near the bottom see the sample below. The number on the left of the check is the bank transit number. The number on the right is your account number. Bank Name Bank Transit Number IMPORTANT Staple your voided check to top right corner of this form* A good copy of your check is acceptable however a deposit form cannot be accepted* FOR A SAVINGS ACCOUNT Please obtain transit routing number and account number from your financial institution* Employee Signature The accuracy of this form is the employee responsibility. Your first check will not be direct deposited however if there are no problems with the first test deposit your 2nd payroll check will go through direct deposit. SAMPLE CHECK Sara Employee 151 Elsewhere St* Charlotte NC 28217 Pay to the Order of Nations Bank 058101896 Bank Account Number 088048818 HR Shared HR Forms Job Packet Forms Direct Deposit Revised 2/03/02. If you choose to do this indicate the dollar amounts to be deposited into each account. Amounts will be deposited for each payroll period every two weeks. Checking Account Amount Savings Account Amount Your name as listed on the Account Your Address as listed on the Account City State Zip Code FOR A CHECKING ACCOUNT The bank transit number and the account number are listed on your checks near the bottom see the sample below. Checking Account Amount Savings Account Amount Your name as listed on the Account Your Address as listed on the Account City State Zip Code FOR A CHECKING ACCOUNT The bank transit number and the account number are listed on your checks near the bottom see the sample below. The number on the left of the check is the bank transit number. The number on the right is your account number. The number on the left of the check is the bank transit number. The number on the right is your account number. Bank Name Bank Transit Number IMPORTANT Staple your voided check to top right corner of this form* A good copy of your check is acceptable however a deposit form cannot be accepted* FOR A SAVINGS ACCOUNT Please obtain transit routing number and account number from your financial institution* Employee Signature The accuracy of this form is the employee responsibility. Bank Name Bank Transit Number IMPORTANT Staple your voided check to top right corner of this form* A good copy of your check is acceptable however a deposit form cannot be accepted* FOR A SAVINGS ACCOUNT Please obtain transit routing number and account number from your financial institution* Employee Signature The accuracy of this form is the employee responsibility. Your first check will not be direct deposited however if there are no problems with the first test deposit your 2nd payroll check will go through direct deposit.

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