ADP Direct Deposit Authorization Form

Information you will need

• What’s the payee’s full name?
• What’s the account type?
• What’s the name of the bank?
• What’s the routing number?
• What’s the bank account number?
• What dollar amount will be deposited?
• Should the full amount be deposited?
• Who’s the payor?
• On what date is this form being completed?

Completed by the employee and the employer and the provider.

The form includes 1 signature line.