City Of Kaukauna Direct Deposit Form printable pdf download

CITY OF KAUKAUNA

IRECT

EPOSIT

City paychecks are automatically deposited in your checking or savings account on payday. You will not

need to change your present banking relationship to accommodate direct deposit with the City.

Here’s how Direct Deposit works:

On payday you’ll receive an earnings statement which shows gross pay, taxes, other deductions, and net

pay (similar to your current pay stub). The net pay will be deposited in your account. The amount of the

deposit will appear on your bank statement. Direct Deposit is safe, convenient, and easy. Every employee

will need to complete the attached authorization form and return it to Craig Pearson in the Finance

Department no later than one week before your first payday.

The authorization form below gives the City and your financial institution the authority to deposit

your pay to your account.

1. Mark the account-type box to indicate whether your pay should be deposited to your checking or

savings account.

2. Fill in your name, name and location of your financial institution, and the date.

3. Attach a voided check (for checking accounts), voided deposit form (for savings accounts) or a

photocopy of either for verification of all financial institution information.

4. If you are unable to provide the document requested in item number 3 above, please contact Craig

Pearson in the Finance Department.

5. Be sure to sign the form!

………………………………………………………………………………………………………...…………..……

Employee’s Authorization – Please fill out and return to the Finance Department.

I authorize my employer, City of Kaukauna, and the financial institution listed below to initiate electronic

credit entries. If necessary, I also authorize debit entries and adjustments for any credit entries which were

incompletely funded by my employer or for any credit entries otherwise in error to my checking or savings

account each payday.

This authority will remain in effect, until I change it in writing. Written authorization to change your account

number must be submitted to the Finance Department one week prior to pay day.

∏ change

∏ as soon as possible

∏ for the payroll dated

____/____/________

____________________________________

_______________________________

Financial Institution

Date

____________________________________

_______________________________

Branch

Name (Please Print)

____________________________________

_______________________________

City, State

Signature

See the reverse side for a sample voided check

Transit/Routing (ABA) Number

∏ Checking account

∏ Savings account

Account Number at Financial Institution

City Of Kaukauna Direct Deposit Form

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