18945 FM 2252 Suite 115 Garden Ridge, TX 78266
Phone: 210-651-0027 Fax: 210-651-0029
Electronic Funds Transfer Authorization
I hereby authorize Cherokee Nation Industries to directly deposit my pay in the bank account(s)
listed below in the amount(s) specified. (If two accounts are designated, deposits are to be
made in whole dollar amounts to the first account.) I have attached a voided check for each
account specified below and have verified the ABA/Transit Number with my bank. This
authorization is to remain in force until the company has received written authorization from
me of its termination or change.
Also, I grant Cherokee Nation Industries the right to correct any Electronic Funds Transfer
resulting from an erroneous overpayment by debiting my account to the extent of such
overpayment.
Name: _____________________________________________________________
Address: ___________________________________________________________
Telephone: ( ) ________________
Signature: ____________________________________ Date: ____________
Account #1 Checking_____________ Savings___________ (Check only one)
Financial Institution: __________________________________________________
Street Address: ______________________________________________________
City, State and Zip Code: ______________________________________________
Telephone: ( ) ________________
Personal Account Number: _____________________ ABA/Transit Number: __ __ __ __ __ __ __ __ __
_______Full Deposit ________ Partial Deposit (amount per payroll) $________________
If partial deposit is checked, then indicate the dollar amount you wish to be deposited per payroll.
$______________