Download 519 Salt Lick Road St. Peters, MO 63376 Direct Deposit Agreement

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519 Salt Lick Road
St. Peters, MO 63376
(636) 3e7-2300
Direct Deposit Agreement Form
I hereby authorize Ameristaff, Inc. to initiate automatic deposits to my account at the financial institution named
below. I also authorize rAmeristaff, Inc. to make withdrawals from this account in the event that a credit entry is
made in error.
Further, I agree not to hold Ameristaff, Inc. responsible for any delay or loss of funds due to incorrect or
incomplete information supplied by me or by my financial institution or due to an error on the part of my financial
institution in depositing funds to my account.
This agreement will remain in effect until Ameristaff, Inc. receives a written notice of cancellation from me or my
financial institution, or until I submit a new direct deposit form to the Payroll Department.
Employee Name:
Name of Financial
lnstitution:
Routing Number:
Checking
n
Account Number:
Date:
Authorized Signature (F']rimary):
Please aftach a voided check or deposit slip.
Savings
!
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