Transcription of DIRECT DEPOSIT / AUTOMATED PAYMENT REQUEST FORM
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DIRECT DEPOSIT / AUTOMATED PAYMENT REQUEST FORM
Box 7889. The Woodlands, Texas 77387-7889. (832) 375-2000. (877) 968-7962 Toll-free DIRECT DEPOSIT / AUTOMATED PAYMENT REQUEST FORM. Complete this form, then print it, sign it and take it to your employer's payroll department to REQUEST electronic DEPOSIT of your check. Employer / Company Name: Address City State Zip Code I (we) authorize the above-named Company to automatically DEPOSIT my check to my (our) Woodforest Checking or Savings account indicated below. This includes my authorization to correct entries made in error. This authorization will remain in effect until I give written notice to cancel it. Checking Account Number: Savings Account Number: OR.
Address City State Zip Code . Customer First Name Middle Name Last Name Signature (required) Date Telephone Number . P.O. Box 7889 The Woodlands, Texas 77387-7889 (832) 375-2000 (877) 968-7962 Toll-free
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