TREMONT THEATRE
Employee Direct Deposit Enrollment Form
To enroll for direct deposit, please fill out this form and send it to Barbara Ellis in Payroll. Attach a voided check for each checking account you want money deposited to. NOT A DEPOSIT SLIP. If depositing into a savings account, ask your bank to give you the Routing/Transit Number for your account. It isn’t always the same as the number on a savings deposit slip. This will help ensure that your money is deposited into the correct bank. The initial deposit takes two (2) weeks.
Below is a sample of a check MICR line, detailing where the necessary information to complete this form can be found.
Important! Please read and sign below before completing and submitting.
I hereby authorize my employer (Tremont Theatre Inc.) to deposit any amounts owed to me by initiating credit entries to my account(s) at the financial institutions (hereinafter “Bank”) indicated on this form. Further, I authorize the Bank to accept any credit entries indicated by Tremont Theatre Inc. to my accounts. In the event Tremont Theatre Inc. deposits funds erroneously into my account(s), I authorize Tremont Theatre Inc. to debit my account for an amount not to exceed the original amount of the erroneous credit.
This authorization is to remain in full force and effect until Tremont Theatre Inc. and Bank have received written notice from me of its termination in such time and in such manner as to afford Tremont Theatre Inc. and Bank reasonable opportunity to act on it.
Employee name:
Social Security Number:
Employee Signature:
Date:
Account Information
The last item must be for the remaining amount owed to you. Make sure to indicate what kind of account, along with amount to be deposited if less than your total net pay check.
- Bank Name/City State:
Routing/Transit #:
Account Number:Circle One: Checking, Savings, Other I wish to deposit: $ - Bank Name/City State:
Routing/Transit #:
Account Number:Circle One: Checking, Savings, Other I wish to deposit: $
| DATE RECEIVED BY PAYROLL: |