Change Payroll Direct Deposit
Please complete, print, sign and submit this form to the appropriate financial institution.
Date
Employer/Depositors Name
Address
City, State Zip
,
State/Province
Alabama
Alaska
Arkansas
Arizona
California
Colorado
Connecticut
Delaware
Florida
Georgia
Hawaii
Iowa
Idaho
Illinois
Indiana
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Missouri
Mississippi
Montana
North Carolina
North Dakota
Nebraska
New Hampshire
New Jersey
New Mexico
Nevada
New York
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Virginia
Vermont
Washington
Washington DC
Wisconsin
West Virginia
Wyoming
Alberta
British Columbia
Manitoba
New Brunswick
New Foundland
Northwest Territory
Nova Scotia
Ontario
Prince Edwards Island
Quebec
Saskatchwan
Yukon Territory
To Whom it May Concern:
You are currently depositing (choose one)
entire paycheck
part of my paycheck:
From the following account:
Old Bank
Bank Routing #
Account #
Please stop making deposits to that account and instead make the deposits to:
Sterling Savings Bank
Bank Routing #
Account #
Attached is a voided check for your reference. If you have any questions regarding this request, please contact me during the:
Day or
Evening: at:
Phone (Area Code, Phone #)
Thank you, Sincerely
Signature (please print form and sign here)
Name
Address
City, State Zip
,
State/Province
Alabama
Alaska
Arkansas
Arizona
California
Colorado
Connecticut
Delaware
Florida
Georgia
Hawaii
Iowa
Idaho
Illinois
Indiana
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Missouri
Mississippi
Montana
North Carolina
North Dakota
Nebraska
New Hampshire
New Jersey
New Mexico
Nevada
New York
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Virginia
Vermont
Washington
Washington DC
Wisconsin
West Virginia
Wyoming
Alberta
British Columbia
Manitoba
New Brunswick
New Foundland
Northwest Territory
Nova Scotia
Ontario
Prince Edwards Island
Quebec
Saskatchwan
Yukon Territory
Other information your employer may need (SSN, Employee ID #, etc)