Woodforest National Bank Direct Deposit Authorization Form

Information you will need

• What’s the company or employer’s name?
• What’s the company’s address?
• What’s the company’s state?
• What’s the company’s city?
• What’s the company’s zip code?
• What’s the checking account number? (if applicable)
• What’s the savings account number? (if applicable)
• What’s the routing number of the checking account?
• What’s the routing number of the savings account?
• What's the customer's first name?
• What's the customer's middle name? (if applicable)
• What's the customer's last name?
• What’s the customer’s address?
• What’s the customer’s city?
• What’s the customer’s state?
• What’s the customer’s zip code?
• What’s the signing date?
• What’s the customer’s phone number?

Completed by the employer.