Fifth Third Bank Direct Deposit Employee Authorization Form

Information you will need

• Who’s the payor?
• What’s the payee’s middle initial?
• What’s the payee’s first name?
• What are the first three digits of the payee's home phone number?
• What are the first three digits of the payee's work phone number?
• What are the last four digits of the payee's home phone number?
• What are the last four digits of the payee's work phone number?
• In what month was the payee born?
• On what day was the payee born?
• In what year was the payee born?
• What are the first three digits of the payee's SSN?
• What are the middle two digits of the payee's SSN?
• What are the last four digits of the payee's SSN?
• What’s the payee’s last name?
• What’s the payee’s email address?
• What’s the payee’s address?
• What's the payee's city?
• What's the payee's state?
• What's the payee's ZIP code?
• What’s the name of the bank?
• What’s the routing number?
• What’s the bank account number?
• What's the purpose of this deposit form?
• What’s the account type?

…and 2 more fields in the PDF.

Completed by the employer and the employee.

The form includes a notary acknowledgment.