Please complete, print, sign and submit this form to the appropriate financial institution.

Date
Employer/Depositor’s Name
Address
City, State Zip ,

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 ,
Other information your employer may need (SSN, Employee ID #, etc)