Employment and HRForm
Direct deposit authorization form template
Collect an employee's bank details and their written permission to pay wages straight into their account, with an optional split between two accounts and the employer's right to correct a payment made in error.
Opens in the Salsox editor with 7 signing fields already placed for Employer and Employee. Add their emails and send. The free plan sends 3 documents a month.
Who signs
- Employer (you)
- Employee
Preview
Direct Deposit Authorization
Employer: Silverline Logistics Inc. Employee: Marcus Delgado Employee ID: E-20418
1. Primary account
| Detail | Entry |
|---|---|
| Account holder name | |
| Bank name | |
| Routing number or sort code | |
| Account number | |
| Account type: checking or savings |
2. Second account, optional
Complete this section only to split your pay between two accounts.
| Detail | Entry |
|---|---|
| Account holder name | |
| Bank name | |
| Routing number or sort code | |
| Account number | |
| Amount or percentage to this account |
The rest of each payment goes to the primary account.
3. Authorization
I authorize Silverline Logistics Inc. to deposit my net pay into the account or accounts above, starting with the pay date of 13 November 2026 or the first pay date after this form is processed. I authorize the employer, and the bank, to correct any deposit made in error, including by reversing an amount paid to me that I was not owed.
I confirm the account details are correct and that I am an account holder. I understand the employer is not responsible for a payment sent to an account using incorrect details I have given.
4. Changes and cancellation
To change or cancel direct deposit, I will complete a new form. This authorization stays in effect until payroll has processed the new form, which may take one pay period.
Employee initials, confirming the details above: Initials · Employee
Signatures
Employee: Signature · Employee Date: Date · Employee Name: Name · Employee
Received for the employer: Signature · Employer Date: Date · Employer Name: Name · Employer
These templates are general starting points, not legal advice. Laws differ between countries and states: check that a template suits your situation, or ask a lawyer, before you rely on it.
About the Direct deposit authorization form template
Paying wages by direct deposit needs two things from the employee: accurate bank details and written authorization. This form collects both in one signed document, which payroll keeps on file and which protects the employer if a payment goes to the wrong account because of details the employee gave.
The employee enters the account holder name, bank, routing or sort code, and account number, and chooses whether to split pay between two accounts. The authorization lets the employer correct a deposit made in error, as banking rules usually allow, and explains how to change or cancel it.
Collect bank details only through a secure channel, and store the signed form with restricted access: it contains information that could be misused. Do not ask employees to email account numbers.
- Signers
- 2
- Signing fields placed
- 7
- Details to fill in
- 4
How to use this template
Open it in Salsox
Choose Use this template. Sign up free if you have no account; the template opens straight after.
Fill in the details
Type your details into each blank, or start from the sample to see how it reads. Save it as your own template to reuse it.
Add signers and send
The editor already has every signature, date and initials field in place. Add each signer's email and send; they sign on their phone, and everyone gets the sealed copy with its audit trail.
Used in
Questions
Can an employer require direct deposit?
It depends on where you are. Some US states, for example, require that employees be offered another option such as a paper check. Check local wage rules.
Why does the form allow corrections?
Banking rules usually let the employer reverse a payment made in error, such as a duplicate. The authorization makes that clear to the employee in advance.
How does an employee change their account?
By completing a new form. The old instructions stay in place until payroll has processed the new one, which section 4 says may take one pay period.
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Send it for signature in minutes
Start from this template in Salsox: fill in the blanks, add your signers and send by email, WhatsApp or SMS. Signers sign one field at a time on their phone, and you can collect a payment in the same step.