Wisconsin Direct Deposit Authorization

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                             This Direct Deposit Authorization form can be used by companies to authorize direct
                             account depositing of funds of their employees. This form obtains the necessary
                             information to complete a direct deposit transaction, such as bank name, account number
                             and routing information. Direct deposit offers a convenient method for employees to
                             receive their paychecks without having to deposit them in person. This document should
                             be used by employers located in Wisconsin that offer direct deposit to their employees.
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                                  DIRECT DEPOSIT AUTHORIZATION




I authorize _____________________________________ [Instruction: Insert the name of the Company]
to send credit entries, as well as appropriate adjustments in debit entries, electronically or by any other
commercially accepted method, to my account as indicated below.


This agreement will remain in effect until _____________________ [Instruction: Insert the name of the
Company] receives a written notice of cancellation from me or until I submit a new Direct Deposit form to
the Payroll Department.




Account #1
Full Legal Name: ______________________
Identification Number: __________________
Social Security Number: ________________


Account Type: __________ Checking __________ Savings.
Instruction: Insert “X” to select the appropriate account
Institution Name: ____________
Bank Routing Number: ________
Account Number: _____________
Percentage to be deposited into this account: _____________________
Instruction: Insert Percentage to be deposited in Account # 1]
Account #2
Full Legal Name: ______________________
Identification Number: __________________
Social Security Number: ________________


Account Type: __________ Checking __________ Savings.
[Instruction: Insert “X” to select the appropriate account]
Institution Name: ____________
Bank Routing Number: ________
Account Number: _____________
Percentage to be deposited into this account: _____________________
[Instruction: Insert Percentage to be deposited in Account # 2]


[Comment: Remove one (1) account section if you do not wish to offer multiple accounts]




                   Please attach a Voided Check for each account here.




[Comment: Write VOID on an unused check and attach here for each Checking Account or for
Savings Deposit slip contact the bank and obtain written verification of the account and routing
numbers. Attach that verification to this form for each savings account.]
______ [Month] ____ [Date], 20___




_______________________________________
                Signature of Employee


_______________________________________
        Type printed name of Employee

				
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Description: This Direct Deposit Authorization form can be used by companies to authorize direct account depositing of funds of their employees. This form obtains the necessary information to complete a direct deposit transaction, such as bank name, account number and routing information. Direct deposit offers a convenient method for employees to receive their paychecks without having to deposit them in person. This document should be used by employers located in Wisconsin that offer direct deposit to their employees.
This document is also part of a package Essential Wisconsin Legal Documents 145 Documents Included