Direct Deposit Authorization Form printable pdf download

DIRECT DEPOSIT AUTHORIZATION FORM

How to switch your direct deposit(s)

To: Payroll Department

Subject: Direct Deposit

to U.S. Bank:

1. For payroll checks - Contact your

From: ____________________________________

Date: _____________________

company’s Human Resources

department for instructions on

This memo serves as notification that I have established a new checking or savings

updating your direct deposit account

account with U.S. Bank. Attached you will find a voided check from my new account.

information.

2. For Social Security checks - Contact

Listed below are the relevant account and routing numbers needed for you to

your local Social Security Administrative

establish payroll Direct Deposit to my new account.

office.

1. U.S. Bank Routing Number: ______________________________________________

If your company does not have a

process in place for updating your

(The first set of numbers found on the bottom of your check)

direct deposit account information,

please follow these steps:

2. U.S. Bank Account Number: ______________________________________________

1. Complete this form.

(The second set of numbers, found after the routing number)

2. Attach a new U.S. Bank check to the

completed form and write “VOID”

Check One:

Checking Account

Savings Account

across the front. Do not sign the check.

3. Submit to your employer.

Print Name:______________________________________________________________

Follow-up on the switch:

Employee Social Security Number: __________________________________________

1. Call your company’s Human Resources

department to check on the progress

If this form is not sufficient to authorize and complete the direct deposit update,

of your request.

please forward the authorized form for my signature.

2. Login to U.S. Bank Internet Banking to

verify your direct deposits are being

Signature: ________________________________

Date:______________________

deposited correctly.

Remember, it can take several

Phone Number:______________________________

payroll cycles for changes to

take effect!

If you have questions, please contact:__________________________________________ at

Thank you for making

U.S. Bank Branch Information: ______________________________________________________

the switch to US!

Branch Phone Number: ________________________________________________________

Branch Fax Number: ______________________________________________________________

usb

Member FDIC

Direct Deposit Authorization Form

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