STAFFING NOW, INC.
DIRECT DEPOSIT/ACH ENROLLMENT APPLICATION
Name:_____=
____________________________________Telephone#________________
Bank Name
& Address: _____________________________________________________
Bank ABA
(Routing) Number:_________________Account Number_________________
Percentage % to this Account:__________________ Check or Savings (please circle one)
Bank Name
& Address: _____________________________________________________
Bank ABA
(Routing) Number:_____________________Account Number_____________
Percentage % to this Account:__________________ Checking or Savings (please circle one)
Staffing
Now, Inc. is hereby authorized to initiate debit and credit entries to my a=
ccount
indicated above and I authorize the financial institution named above to de=
bit
or credit same account. This
authority is to remain in full force and effect until Staffing Now, Inc. has
received written notification from me of its termination in such time and s=
uch
manner as to afford Staffing Now, Inc. and/or the financial institution abo=
ve a
reasonable opportunity to act on it.
Attach a copy of your voided check (do not inc=
lude
a deposit slip)
<= o:p>
Assuming you have provided Staffing Now with the corr=
ect
banking information, you should plan that the next TWO PAY PERIODS y=
ou
will be paid with a regular paycheck.
On the THIRD PAY PERIOD, the money will be automatically
deposited into your bank account.
The paycheck stubs will be mailed to your address on
file.
_____ At this time, I wish to stop my direct deposit.=
Signature:
____________________________SS#___________ Date:_______________