Georgia Direct Deposit Form 2 - Free Download
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PayrollDirectDepositForm
Date:__________
NameofCompany:________________________________
CompanyAddress:________________________________
City:______________________State:____Zip:_________
Attn:DirectDepositDepartment
ToWhomItMayConcern:
I,__________________________________authorizeyoutoterminatemycurrentdirectde posit andstart
depositingintomynewfinancialinstitution.
Iwouldliketostopmydirectdepositto:PreviousFinancialInstitution:________________________________
RoutingNumber:__________________________AccountNumber:______________________
Iwouldliketost
artmydirectdepositto:
RobinsFederalCreditUnion,POBox6849,WarnerRobins,GA31095‐6849
RoutingNumber:261171587AccountNumber:________________________
MarkBox:CheckingorSavings
AmountofDeposit:MarkboxNetPayortypespecificamount:$_________________
Signature:_____________________________________
Forwardcompletedformtoyourpayrollofficeoranyotherorganizationthatregularlysendsyouapayment.
803WATSONBOULEVARD•P.O.BOX6849•WARNERROBINS,GEORGIA31095
478.923.3773•800.241.2405
www.robinsfcu.org