Canada Chase Direct Deposit Form

Chase Direct Deposit Form

DIRECT DEPOSIT REQUEST FORM

Instructions

Complete this form, then print it, sign it and take it to your employer’s payroll department to request direct deposit of your paycheck.

Customer Name

Address

City

State

Zip Code

Please have my paycheck automatically deposited into the following account:

Checking account number

Savings/MIA/Money market account number

Your bank’s routing number

You can find your account and routing numbers when you sign in to chase.com:

• Click on the last four digits of your account number that appear above your account information, or
• Select the “Account & routing number PDF” from the “Things you can do” menu.

I authorize First Corp International Inc. and my bank to automatically deposit my paycheck into my account listed above (this includes my authorization to correct entries made in error). This authorization will remain in effect until I give written notice to cancel it.

Signature

Sign Here

Date