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Direct Deposit ACH Authorization Form Employee Information First Name:_______________________________ MI ______ Last Name_____________________ ______________________________________________________________________ City_________________________ State___________________________________Zip ____________ Email Address ________________________________________________________________________ Home Phone (include area code) _____________________________________ Cell Phone (include area code) _______________________________________ I wish to receive my payroll checks by Direct Deposit. I hereby authorize Theoriginate electronic credit transactions to my bank (or credit union or savings & loan) account indicated below.