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131 - Direct Deposit Form

This document is a direct deposit request form for an employee of Mastech, Inc. It requests the employee's name, employee ID, phone number, social security number, client/location, and email. It also requests the name, address, routing number, and account number of the employee's financial institution as well as whether they want full or partial deposit to their checking, savings, or other account. The employee must attach a voided check or deposit slip and their first paycheck will be a paper check. The form also allows employees to provide different account information for expense reimbursement direct deposits. By signing, the employee authorizes Mastech to directly deposit their pay and expense reimbursements into the designated account(s

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Dipika Kasyap
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© Attribution Non-Commercial (BY-NC)
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307 views1 page

131 - Direct Deposit Form

This document is a direct deposit request form for an employee of Mastech, Inc. It requests the employee's name, employee ID, phone number, social security number, client/location, and email. It also requests the name, address, routing number, and account number of the employee's financial institution as well as whether they want full or partial deposit to their checking, savings, or other account. The employee must attach a voided check or deposit slip and their first paycheck will be a paper check. The form also allows employees to provide different account information for expense reimbursement direct deposits. By signing, the employee authorizes Mastech to directly deposit their pay and expense reimbursements into the designated account(s

Uploaded by

Dipika Kasyap
Copyright
© Attribution Non-Commercial (BY-NC)
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as XLS, PDF, TXT or read online on Scribd
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MASTECH, INC.

DIRECT DEPOSIT REQUEST FORM EMPLOYEE INFORMATION


NAME EMP ID# ( ) DAYTIME PHONE NUMBER -

SOCIAL SECURITY NUMBER

CLIENT / LOCATION

EMAIL

DIRECT DEPOSIT INFORMATION


NAME OF FINANCIAL INSTITUTION

ADDRESS

CITY

STATE

ZIP

TRANSIT ROUTING NUMBER DEPOSIT TYPE: FULL DEPOSIT PARTIAL DEPOSIT CHECKING

ACCOUNT NUMBER ACCOUNT TYPE: SAVINGS OTHER $___________CHECKING $___________ SAVINGS $ ___________OTHER

* PLEASE ATTACH A VOIDED CHECK FOR CHECKING ACCOUNTS AND A DEPOSIT SLIP FOR SAVINGS ACCOUNTS. YOUR FIRST PAYCHECK WILL BE A "LIVE" CHECK AS ACCOUNT INFORMATION MUST BE VERIFIED BEFORE DIRECT DEPOSIT CAN BEGIN. ONLY THE FULL AMOUNT OF AN EXPENSE REIMBURSEMENT CHECK MAY BE DEPOSITED.

DIRECT DEPOSIT EXPENSE REIMBURSEMENT INFORMATION


(COMPLETE ONLY IF DIFFERENT THAN ABOVE)

NAME OF FINANCIAL INSTITUTION

ADDRESS

CITY

STATE

ZIP

TRANSIT ROUTING NUMBER ACCOUNT TYPE: CHECKING SAVINGS

ACCOUNT NUMBER

AUTHORIZATION AGREEMENT FOR DIRECT DEPOSIT


I HEREBY AUTHORIZE THE DIRECT DEPOSIT OF MY PAY AND/OR EXPENSE REIMBURSEMENT BY MASTECH, INC. INTO THE BANK ACCOUNT(S) OF THE INSTITUTION(S) INDICATED ABOVE. MASTECH WILL MAKE DIRECT DEPOSITS TO MY ACCOUNT IN ACCORDANCE WITH THE PUBLISHED PAYROLL SCHEDULE AND UPON APPROVAL OF MY EXPENSE REPORTS. IN THE EVENT THAT MASTECH ERRONEOUSLY DEPOSITS FUNDS INTO MY ACCOUNT, I AUTHORIZE MASTECH TO DEBIT MY ACCOUNT FOR AN AMOUNT NOT TO EXCEED THE ORIGINAL AMOUNT OF THE CREDIT, OR IF NO LONGER EMPLOYED BY MASTECH, TO REIMBURSE SUCH OVERPAYMENTS DIRECTLY TO MASTECH WITHIN 30 DAYS OF THE OVERPAYMENT(S). I MAY TERMINATE THIS AGREEMENT IN WRITING AT ANY TIME WITH THE UNDERSTANDING THAT TERMINATION OF DIRECT DEPOSITS INTO MY ACCOUNT(S) WILL BECOME EFFECTIVE WITHIN 15 (FIFTEEN) DAYS OF MASTECH RECEIVING WRITTEN NOTIFICATION.

EMPLOYEE SIGNATURE

DATE
REV 7/09

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