This form is often used by companies giving their banks permission to allow a particular employee to act on their behalf in depositing money directly to their bank account. The form is filled by a person in authority in the company and presented to the bank’s operations manager or branch manager. Here is a sample direct deposit authorization form.
Company name: ___________________________________________________________
Physical Address: ______________
City: ________________ State/Province: __________
Zip / Postal Code: ____________ Country: ________________ Phone: _______________
Employee’s Name: __________________________________________________________
Employee I.D. Number _______________
Employee’s Social Security Number ___________
Bank Name: _______________________
Branch: ________________________________
Bank Address: ______________
City: _______________ State/Province: ______________
Zip / Postal Code: ___________
Country: _______________
Phone: _________________
Account Number: ____________________________ (savings or checking account number)
This is an authorization to the bank to deposit the full amount of my paycheck directly into the account number in the named bank.
Name ____________________________________________________________________
Signature _______________________________ Date ________
