Transcription of DIRECT DEPOSIT / AUTOMATED PAYMENT REQUEST FORM
1 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.
2 Routing Number: Routing Number: You can find your account number on your statement If monies to which I am not entitled are deposited to under the Summary of Account section. Routing number my account, I authorize the Company (issuer) to DIRECT information is located here: the financial institution to return said funds and I. authorize the financial institution to act on the number Company's direction and to return said funds. Customer First Name Middle Name Last Name Address City State Zip Code Signature (required) Date Telephone Number If Woodforest can be of further assistance or additional information is required, please contact our Verification Department at 832-375-2101 or call (toll-free) at 1-877-968-7962.
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