Georgia Direct Deposit Form 2
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Payroll Direct Deposit Form 
Date:  __________ 


Name of Company:  ________________________________ 
Company Address: ________________________________ 
City:  ______________________   State:  ____     Zip:  _________

Attn:  Direct Deposit Department 

To Whom It May Concern: 
I, __________________________________ authorize you to terminate my current direct deposit and start 
depositing into my new financial institution. 
I would like to stop my direct deposit to:  Previous Financial Institution: ________________________________ 
Routing Number: __________________________      Account Number: ______________________ 
I would like to start my direct deposit to:  
Robins Federal Credit Union, PO Box 6849, Warner Robins, GA 31095‐6849 
Routing Number: 261171587                          Account Number: ________________________ 
Mark Box: Checking            or Savings 
Amount of Deposit:  Mark box       Net Pay or type specific amount: $_________________ 


Signature: ______________