Direct Deposit Authorization Form (40)

Create Document

Direct Deposit Authorization Form (40)

A direct deposit authorization form is a document that enables an employer to transfer money directly into the bank account of an employee on their payroll. It can also be used by independent contractors to collect payments from their clients. The form requires the payee’s account info, a statement of consent, and their signature.

Create Document
Fill Now
Download
Word
ODT

Last updated June 3rd, 2025

Document Preview

A direct deposit authorization form is a document that enables an employer to transfer money directly into the bank account of an employee on their payroll. It can also be used by independent contractors to collect payments from their clients. The form requires the payee’s account info, a statement of consent, and their signature.

Downloads: 626

Benefits of Direct Deposit Enrollment

  • Eliminates the need for paper checks.
  • Funds are typically available on payday without delays.
  • Electronic transfers reduce the risk of lost or stolen payments.
  • Convenience for employers and employees (no need to visit the bank).

By Type (40)

ADP

Ally Bank

America First

American Express

Bank of America

Bank of Montreal (BMO)

BECU

Capital One

Cash App

Chase

Chime

Citibank

Citizens Bank

Discover

Fidelity Investments

First Citizens Bank

First Third Bank

Frost Bank

Huntington Bank

IHSS

Intiut (QuickBooks)

KeyBank

M&T Bank

Navy Federal Credit Union

Paychex

PNC Bank

RBFCU

Regions Bank

Santander Bank

Schools FCU

SECU

Social Security

Standard Form 1199A

Suncoast Credit Union

TD Bank

Truist

US Bank

USAA

Wells Fargo

Woodforest National

When to Use a Direct Deposit Form

A direct deposit authorization form is used when someone wants recurring payments deposited directly into their bank account. While it most commonly applies to employee payroll, it’s also suitable for electronic transfers of:

  • Child support.
  • Social Security.
  • Government benefits.
  • Pension income.

How to Fill Out a Direct Deposit Form

  1. Provide Personal Information – The payee’s name, address, and employee ID or Social Security number (if required) should be provided.
  2. Describe Bank Account – A few banking details are needed:
    • Name of financial institution
    • Type of bank account (checking, savings, money market, etc.)
    • Routing and account numbers
  3. Enter Deposit Instructions – Payees can deposit the full amount, a portion, or split the payment between multiple accounts (if the payor allows it).
  4. Identify Payor – Deposit forms must identify the employer or other organization issuing payments.
  5. Sign and Date – A dated signature is needed for authorization.

Sample

Download: PDF, Word (.docx), OpenDocument

DIRECT DEPOSIT AUTHORIZATION

Name: [PAYEE NAME]     Address: [PAYEE ADDRESS]

Name of Bank: [NAME OF BANK] 
Account #: [ACCOUNT NUMBER] 
9-Digit Routing #: [ROUTING NUMBER]

Amount: ☐ $ [DOLLAR AMOUNT]    ☐ [PERCENTAGE] % or  ☐ Entire Amount
Type of Account:   ☐ Checking      ☐ Savings

Attach a voided check for each bank account to which funds should be deposited (if necessary).

[PAYOR NAME] is hereby authorized to directly deposit my pay to the account listed above. This authorization will remain in effect until I modify or cancel it in writing.

Payee Signature: ______________________    Date: [MM/DD/YYYY]