ACH Direct Deposit of Payroll

Authorization Form
Saint Peter Public Schools is requesting all employees and substitutes of the district to use automatic deposit for all payroll
checks.
The form is required to set up automatic deposit of your payroll check into your checking or savings account(s).
Please remember to attach a voided check. If you have any questions please call Cheri Portner at 934-5703, ext. 223

I _________________________________ hereby authorize SAINT PETER PUBLIC SCHOOLS to initiate credit entries
(Employee Name)
of such adjusting entries, either debit or credit, which are necessary for corrections, to my account(s) indicated below and the
financial institution(s) named below to credit (or debit) the same to such account(s).

Financial Institution Name

Amount $

Transit/Routing #

Percent %

Account #

Balance
Checking

Savings

(For Multiple Accounts only)

Financial Institution Name

Amount $

Transit/Routing #

Percent %

Account #

Balance
Checking

Savings

Financial Institution Name

Amount $

Transit/Routing #

Percent %

Account #

Balance
Checking

Savings

PLEASE ATTACH VOIDED CHECK

Signature-
_____________________________________________

Date
-_____________________