AUTHORIZATION FOR PAYROLL DIRECT DEPOSIT
Name:
Check Applicable Election:
New Participant Add a new account
Change of Accounts and/or financial institution.
I opt to not utilize direct deposit but & choose the PayCard option
For all elections, your pay will be a direct deposit immediately to the account(s) of your choice, including the paycard option.
You have the option to have your pay deposited in up to three (3) accounts.
Sequence 1
Financial Institution:
Account Type:
Checking
Amount
Savings
OR
Percentage
Sequence 2 or Remaining
Financial Institution:
Account Type:
Checking
Amount
Savings
OR
Percentage
Sequence 3 or Remaining
Financial Institution:
Account Type:
Checking
NET
Amount
Savings
OR
Percentage
PLEASE ATTACH A VOIDED CHECK, IN THE CASE OF SAVINGS ACCOUNTS A VOIDED DEPOSIT SLIP, OR SOMETHING YOUR
FINANCIAL INSTITUTION CAN ISSUE TO YOU FOR PROPER VERIFICATION OF FINANCIAL INSTITUTION INFORMATION.
AUTHORIZATION STATEMENT:
I hereby authorize MORGAN HUNTER COMPANIES and the financial institution(s) above to deposit my pay electronically to my account
each pay period. This authority will remain in effect until I have signed a new authorization, upon cancellation of participation or upon
termination of employment. I acknowledge that the origination of ACH transactions to my account(s) must comply with the provisions of
U.S. law.
Signature
Date
revised 10/4/10