Employee Authorization Form – Used to authorize the direct deposit of claim reimbursements for an account holder’s benefit plan.
Enrolling in Direct Deposits
To receive paychecks via direct deposit, employees must submit a voided check and a completed direct deposit authorization form to their employer. The direct deposit form must include the following:
- Employee’s personal information, including Social Security number
- Account and routing numbers for each deposit account
- Desired deposit amount
- Dated signatures of the employee and the employer