Employee Direct Deposit Authorization Employee Direct Deposit Authorization Instructions Employee: Fill out and submit to employer. This document must be signed by employees requesting automatic deposit of paychecks and retained on file by the employer. Do not send this form to Intuit. Employees must attach a voided check for each of their accounts to help verify their account numbers and bank routing numbers. Account 1 Account Type * Checking Savings Account number: * Bank routing number (ABA number): * Account 2 Account Type Checking Savings Account number: Bank routing number (ABA number): Voided Check Upload a voided check for each account here Choose File Maximum file size: 104.86MB <p><span style="font-weight: 400;">This authorizes</span> <span style="font-weight: 400;">HSE Staffing Agency to send credit entries (and appropriate debit and adjustment entries), electronically or by any other commercially accepted method, to my (our) account(s) indicated below and to other accounts I (we) identify in the future (the “Account”). This authorizes the financial institution holding the Account to post all such entries. I agree that the ACH transactions authorized herein shall comply with all applicable U.S. Law. This authorization will be in effect until the Company receives a written termination notice from myself and has a reasonable opportunity to act on it.</span></p> Authorized signature Clear Employee ID # Print name * Date * If you are human, leave this field blank. Submit
