Authorization Agreement for Direct Deposit

Authorization Agreement for Direct Deposit

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Full Name *

First Name Last Name
Tax ID Number *
SSN or Employer ID
E-mail *
*Copy of submission will be emailed to you*
Bank Information (May List Multiple Using +) *
Please Check One:

New or Additional Direct Deposit Change the Bank or Account Number on an Existing Direct Deposit* Change the Amount of an Existing Direct Deposit* Other (please explain)
*If Changing Bank/Acct # of Existing DD - List New Account # to be Replaced:
New Account #
*If Changing Amount of Existing DD - List Previous Amount - Changed Amount
Amount Was - Amount Changed To

Upload a voided personalized check (checking accounts) or deposit slip (savings accounts) for each account specified. (This request will not be processed without the accompanying documentation.) - Drag + Drop Below (Single Upload File Below) *

Upload a File
Voided Check/Deposit Slip Cancel of
W-9 (Submit an updated/current W9 - we cannot issue payment until received)

Upload a File
Current Signed W-9 Cancel of

Check Box to Agree:

I hereby authorize Sousa Court Reporters to directly deposit any salary or wages due to me, less any mandatory or authorized withholdings or deductions in the bank account(s) listed above in the percentages specified. (If two or more accounts are designated, deposits are to be made in whole percentages of pay to total 100%.) I hereby grant Sousa Court Reporters the right to correct any such electronic funds transfer resulting from an erroneous over-payment by debiting my account to the extent of such over-payment. I authorize my financial institution to accept direct deposits to my account upon receipt and without advice to me. It is my responsibility to verify deposits on a per pay date basis before writing checks against these funds. I understand that Sousa Court Reporters is not responsible for bank errors or bank fees. Banking services are provided in accordance with the limitations and restrictions of the Automated Clearing House Association. This authorization is to remain in force until Sousa Court Reporters has received written authorization from me of its termination or change. I understand that if my account has closed, my financial institution cannot accept a deposit on my behalf. If this occurs, my employer will not be able to process any further direct deposits without further written authorization from me. IN ORDER TO TERMINATE OR REVOKE THIS AUTHORIZATION, I MUST NOTIFY MY EMPLOYER IN WRITING AT LEAST TWO WEEKS PRIOR TO THE TERMINATION.
Sousa Court Reporters will credit my account(s) the amount of my payroll check on payday. Deposits are normally available the morning of pay date however each bank posts funds to accounts at different times daily, and Sousa Court Reporters has no control over my bank’s posting. (Initials below) *
Signature: *

Clear
Date

Month Day Year
Please allow 1-2 payroll processings for your direct deposit to begin while we test the account and routing numbers. Please verify with your bank that your first direct deposit has been processed correctly.
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