Authorization for Direct Deposit

I authorize you and the financial institution listed below to initiate electronic credit entries, and if necessary, debit entries and adjustments for any credit entries in error to my:

each payday. This authority will remain in effect until I have cancelled it in writing.

Financial Institution

Routing No.

Accout No.

Signature

Date

Century Traffic is offering all employees the option to direct deposit their paycheck into more than one account. This can be in the form of a percentage or a set amount every week. For those of you who are interested in this option, please fill out the bottom portion of this form also:

Account No.

% or $ per week

Routing No.

Signature

Date

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Authorization for Direct Deposit

Authorization For Direct Deposit

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