Sample Direct Deposit Authorization Form - This authorization will remain in effect until i modify or cancel it in writing. (check one) attach a voided check for each bank account to which funds should be deposited (if necessary) _____________________ [company name] is hereby authorized to directly deposit my pay to the account listed above.
(check one) attach a voided check for each bank account to which funds should be deposited (if necessary) _____________________ [company 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.