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Get TD Bank Direct Deposit Authorization Form

DIRECT DEPOSIT AUTHORIZATION FORM TD Bank makes setting up direct deposit easy with this convenient pre-filled form. There are two types of direct deposit enrollment available Federal Government Benefit Compensation and Payroll Compensation. Steps to enroll for each are outlined below. 1. FEDERAL GOVERNMENT BENEFIT COMPENSATION To sign up for direct deposit of your federal benefit payments such as Social Security SSI or VA Compensation and Pension Payment Go to the U*S* Department of the Treasury website www. godirect. org or Enroll by phone by calling the U* S* Department of the Treasury toll free at 1-800-333-1795 You ll need your Social Security Number or claim number 12-digit federal benefit check number Amount of most recent federal benefit check TD Bank s Routing Transit Number TD Bank Account Number Type of Account checking or savings 2. PAYROLL COMPENSATION Complete and sign this direct deposit form and give it to your employer s payroll representative it s that easy EMPLOYEE NAME AND ADDRESS EMPLOYEE PHONE NUMBER EMPLOYEE ID if applicable EMPLOYEE SOCIAL SECURITY NUMBER Please begin directly depositing my payroll and/or dividend or annuity check into my account at TD Bank. l Total net check amount l The set amount of of my net check each period BANK NAME TD Bank N*A. ADDRESS 32 Chestnut St* PO Box 1377 Lewiston ME 04243-1377 TD BANK ROUTING TRANSIT NUMBER TD BANK ACCOUNT NUMBER TYPE OF ACCOUNT Employee Signature Date 11440C-CHK 09/11. 1. FEDERAL GOVERNMENT BENEFIT COMPENSATION To sign up for direct deposit of your federal benefit payments such as Social Security SSI or VA Compensation and Pension Payment Go to the U*S* Department of the Treasury website www. godirect. org or Enroll by phone by calling the U* S* Department of the Treasury toll free at 1-800-333-1795 You ll need your Social Security Number or claim number 12-digit federal benefit check number Amount of most recent federal benefit check TD Bank s Routing Transit Number TD Bank Account Number Type of Account checking or savings 2. godirect. org or Enroll by phone by calling the U* S* Department of the Treasury toll free at 1-800-333-1795 You ll need your Social Security Number or claim number 12-digit federal benefit check number Amount of most recent federal benefit check TD Bank s Routing Transit Number TD Bank Account Number Type of Account checking or savings 2. PAYROLL COMPENSATION Complete and sign this direct deposit form and give it to your employer s payroll representative it s that easy EMPLOYEE NAME AND ADDRESS EMPLOYEE PHONE NUMBER EMPLOYEE ID if applicable EMPLOYEE SOCIAL SECURITY NUMBER Please begin directly depositing my payroll and/or dividend or annuity check into my account at TD Bank. PAYROLL COMPENSATION Complete and sign this direct deposit form and give it to your employer s payroll representative it s that easy EMPLOYEE NAME AND ADDRESS EMPLOYEE PHONE NUMBER EMPLOYEE ID if applicable EMPLOYEE SOCIAL SECURITY NUMBER Please begin directly depositing my payroll and/or dividend or annuity check into my account at TD Bank. l Total net check amount l The set amount of of my net check each period BANK NAME TD Bank N*A. ADDRESS 32 Chestnut St* PO Box 1377 Lewiston ME 04243-1377 TD BANK ROUTING TRANSIT NUMBER TD BANK ACCOUNT NUMBER TYPE OF ACCOUNT Employee Signature Date 11440C-CHK 09/11. .

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