Direct Deposit Authorization Form

Direct Deposit Authorization Form

Account Type (select one):
Select which account to direct deposit funds.
Input the name of your financial institution.
Input the address of your financial institution.
Input the Bank Routing Number / ABA Number of your financial institution.
Input the Bank Account Number of your financial institution.
Percentage to Be Deposited Into This Account. (If you are including a second account, please note that the percentages to be deposited in the two accounts must total 100%)
Accepted file types: jpg, gif, png, pdf, Max. file size: 256 MB.
ATTACH IMAGE OF VOIDED CHECK (CHECKING ACCOUNT) OR DEPOSIT SLIP (SAVINGS ACCOUNT)
ELECTRONIC SIGNATURE ACKNOWLEDGEMENT AND CONSENT
I, agree and understand that by signing the Electronic Signature Acknowledgment and Consent Form, that all electronic signatures are the legal equivalent of my manual/handwritten signature and I consent to be legally bound to this agreement.
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