Paychex Direct Deposit Form | Fillable PDF | Word
The Paychex Direct Deposit Form is both for new employees and for any other employee who wants to make any changes in the way his of her paycheck is being deposited.
How to Write
At the very top of the form, you enter your complete name and the last four digits of your social security number. The entire social security number is not needed.
The next part of the form is entitled “Complete to Enroll or Change Enrollment in Direct Deposit” There are five columns here, and two identical rows.
The first column is for your Bank Account Number. Fill this in on the first row. Moving along on the first row, the second column is for the Type Of Account. Here, you check one of three boxes for either “savings”, “checking” or “Chase Pay Card Plus”. If you choose the last option, there is an attached application to fill out.
Continuing on the first row, the next column is for “Deposit Type”. Here, there are three choices. If you want your entire paycheck deposited into this bank account, chock the box titled “Remainder of Net Pay”. If you want any given percentage of your pay to go into this bank account, check the second box, which is “__% of Net”, and, of course, you fill in the blank with the percentage that you choose. If you want a specific dollar amount to go into this account in any given pay period, check the last box under this column, “Specific Dollar Amount $__.00”. You fill in the blank with the dollar amount you choose.
There is also a final column is very similar to the previous “Deposit Type” column. It is for changes to the way your paycheck is already being deposited. If there are no changes to be made, leave it blank.
The second row in this part of the Paychex Direct Deposit Form is for recipients who have a second bank account into which you wish to deposit funds each pay period. It is completed in the exact same manner as you filled in the first row.
The next part of the Paychex Direct Deposit Form asks you attach one of three items, and includes three boxes, one of which you will check to indicate your choice. The first choice is for a voided check imprinted with your name and checking account number. Starter checks can’t be accepted. The second option is for a deposit slip, which must include the verbiage “ACH R/T” appearing before the routing number. The final acceptable choice is letter from your bank with the appropriate information, signed by a bank representative.
The last part of the Paychex Direct Deposit Form for you, the employee, to fill out is the Worker Confirmation Statement. You will sign and date the form here. If the bank account you are depositing into is under someone else’s name, such as your spouse or parent, there is also a space for him or her to sign.
Download (DOC, 62KB)