Direct Deposit Authorization Form

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Direct Deposit Authorization
®
This form allows you to start funding your myRA
by setting up direct deposit from your paycheck. Additional direct
deposit authorization forms are available at myRA.gov. In some cases, employers may ask you to use their own
paper or electronic process to set up payroll direct deposit.
How to set up direct deposit to your myRA account:
1. Complete all sections and sign this form.
2. Give the completed form to your employer.
Note: Keep a copy of the completed form for your records. It may take up two pay periods before you see the
first deposit from your paycheck in your myRA.
EMPLOYEE INFORMATION
Name:____________________________________________________________________________________
Phone Number: ____________________________________________________________________________
Street Address: ____________________________________________________________________________
City/State/ZIP: _____________________________________________________________________________
Employer Name: ___________________________________________________________________________
Please consider this request, as indicated by my original signature below, as formal authorization and order to
make any recurring direct deposit(s) to the myRA account at Comerica Bank listed below. I acknowledge that the
origination of ACH transactions to my account must comply with the provisions of U.S. law.
ACCOUNT INFORMATION
myRA Routing Number: 111925074 ___________________________________________________________
myRA Account Number: ____________________________________________________________________
Note to Employer: Code the account type (i.e. deposit) as “savings.”
DIRECT DEPOSIT INFORMATION
I would like to direct deposit this amount per pay period: $ ________________________________________
I would like this to take effect:
Immediately
As of this date ____________________________
Name: ___________________________________________________________________________________
Please print your first and last name
Signature: __________________________________________ Date: ________________________________
This authorization will remain in full force and effect until your employer has received notification from you of its
termination. If you decide to revoke your authorization, then you may only do so by contacting your employer directly (as
determined by your employer), and in such time and manner to provide your employer and Comerica Bank reasonable
time to process the termination request.

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