Direct deposit authorization form
A direct deposit form with the employee's bank, routing and account numbers, account type, split between accounts and a signed authorization.
- ๐บ๐ธ US format ยท Letter size
- Free
This is a sample form. Check that the terms and pay match federal and state labor rules and your company policy.
Fill in what you need. The preview updates as you type.
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Verify before the first deposit
This is a general template, not legal advice. The employer verifies the routing number with the bank or against the voided check before the first deposit. Most payroll providers run a small prenote (test) transaction first, so the first real paycheck may still be a paper check.
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Direct Deposit Authorization
| Employee | Jordan Lee | Employee ID | EMP-0231 |
|---|---|---|---|
| Employer | Acme Inc. | Date | October 5, 2026 |
| Account 1: bank name | First National Bank of Austin | ||
| Routing number (9 digits) | 111000025 | Account number | 0012345678 |
| Account type | โ Checkingย ย โก Savings | Amount | Remaining net pay after account 2 |
| Account 2: bank name | ย | ||
| Routing number (9 digits) | ย | Account number | ย |
| Account type | โก Checkingย ย โก Savings | Amount | $200.00 per paycheck |
| Attach | A voided check or a bank letter for each account. A deposit slip is not enough, because its routing number can differ. | ||
I authorize Acme Inc. to deposit my pay to the account(s) listed above and, if money is deposited in error, to withdraw the same amount from that account. This authorization stays in effect until I give Acme Inc. written notice to change or cancel it, allowing a reasonable time for the change to take effect. I will tell Acme Inc. right away if I close an account. October 5, 2026 Employee signature: Jordan Lee To: Payroll | |||
| For employer use: received by | ย | Date received | ย |
|---|---|---|---|
| Routing number verified with the bank | โก Yes | Effective pay date | ย |
How to use it
Type the bank name, the 9-digit routing number and the account number, and pick checking or savings. If you want part of each paycheck in a second account, turn on the second account and choose a percent or a fixed dollar amount; the form prints the split and leaves the second account's details to fill by hand. Sign, attach a voided check for each account and give it to payroll.
Payroll fills in the employer box at the bottom: who received the form, that the routing number was verified and the first pay date the deposit applies to. Keep the signed form with the payroll records, not in the general personnel file.
Things to watch
A deposit slip is not a substitute for a voided check: deposit slips sometimes carry an internal routing number that does not work for ACH. The preview checks the routing number's length and check digit, but it cannot confirm the account number, so compare both against the check before you sign.
Calculators that go with this
Frequently asked questions
Where do I find the routing and account numbers?
On a check, the routing number is the 9-digit number at the bottom left and the account number follows it. Online banking shows both under account details. Savings accounts have the same routing number as checking at the same bank in most cases.
Can an employer require direct deposit?
It depends on the state. Several states let employers require it as long as the employee can choose the bank; others require a paper check or pay card option. Payroll will know the rule where you work.
How do I change or cancel it later?
Fill in a new form with the new account and write Replaces the authorization dated ____ in the notes. Keep the old account open until the first deposit lands in the new one.
Is what I type saved anywhere?
No. Everything stays in your browser and nothing is sent to our server. If you refresh the page it is gone, so print, save a PDF or download the DOCX when you are done.