Form Bank Authorization Bank Authorization Authorization To Debit Bank Account CompanyThis field is for validation purposes and should be left unchanged.Client NameClient authorizes AMERICA’S PAYROLL as the “Payroll Service Provider”, or it’s Agent(s), to initiate debit entries for collection of the following: a) Payroll Tax Obligations b) Employee Direct Deposits (if applicable) c) Applicable Payroll Service Fees Such entries will be debited out of the Client’s current payroll account or the account indicated by the sample “VOID CHECK” provided by the Client. This account may change from time-to-time. When such change occurs, the Client agrees to provide the new account information to the Payroll Service Provider.Attach VOID CheckMust be a VOID check. Deposit receipts do not provide sufficient information.Accepted file types: jpg, jpeg, gif, png, pdf, Max. file size: 1 GB. Name First Last TitleSignatureDate MM slash DD slash YYYY Consent I hereby certify that I am a signatory to this account and I have the authority to execute this agreement. Find What You’re Looking ForForms Payroll Service AgreementAgreement for Professional Payroll Services View Form Bank AuthorizationAuthorize Americas Payroll to debit your bank account View Form Direct Deposit AuthorizationComplete this form only if you have Employee Direct Deposits View Form
