EmailMeForm
G11 Security Direct Deposit Authorization
Employee or Contractor: Fill out and submit to your employer.
Employer: Save for your files only.
This document must be signed by employees requesting automatic deposit of paychecks and retained on file by the employer. Do not send this form to Intuit. Employees must attach a voided check for each of their accounts to help verify their account numbers and bank routing numbers.
Name
*
First
MI
Last
Suffix
Address
Street Address
City
State / Province / Region
Postal / Zip Code
Email
*
Confirm
Phone
*
###
-
###
-
####
Banking Account
Please make sure information is CORRECT!
Account 1 type:
*
Checking
Savings
Bank routing number (ABA number):
*
Number 1
Bank account number (ABA number):
*
Account number:
Cash App
*
$
Indicate Cash App Handle
Percentage or dollar amount to be deposited to this account:
How much do you want in each account.
File Upload
Attach a picture of a voided check for each account here
Authorization:
This authorizes my employer to send credit entries (and appropriate debit and adjustment entries), electronically or by any other commercially accepted method, to my (our) account(s) indicated below and to other accounts I (we) identify in the future (the “Account”). This authorizes the financial institution holding the Account to post all such entries. I agree that the ACH transactions authorized herein shall comply with all applicable U.S. Law. This authorization will be in effect until the Company receives a written termination notice from myself and has a reasonable opportunity to act on it.
Authorized signature:
Clear
Print name:
*
First
Middle
Last
Suffix
Web Site
