Chase Bank Direct Deposit Form
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Save Time with Direct Deposit

It’s safe, simple and it saves time.

Employer Direct Deposit Sign-Up Form
Take this completed form to your employer’s payroll department to request direct deposit of your payroll check.

Why Direct Deposit?

Customer Name

It’s convenient and it saves time.

Address

• Your check’s automatically

deposited into your account.

• It eliminates a trip to the bank.
• Your money is available in your
account on payday.

City

• You’ll receive a paper voucher for
your records.

Zip Code

Please have my payroll check automatically deposited into the
following account:

It’s safe and secure.
• No more lost or misplaced checks.
• Confirm your deposit by phone or
online.

State

Checking Account Number

or
Savings/MIA/Money Market Account Number
Bank’s Routing Number

It’s simple... here’s how.
• Payroll Checks
Take this completed application
form to your employer’s payroll
department. Include a voided check
so your employer can confirm your
account and routing/tra