ࡱ> IKJ[ 9bjbj :.ΐΐl83Dw,?2j(///1111111$3K61/,j///11:1:1:1/pp1:1/1:1:1W:1TAZ0p:1120?2:160p6:16:1p//:1/////11:1///?2////6///////// : Direct Deposit Authorization Forms Employee Name: I hereby authorize RANDCOL, LLC to deposit my pay directly into the bank account(s) listed below. I have attached a voided check or deposit slip for each account so bank transit and account numbers can be verified. I also authorize RANDCOL, LLC to correct any erroneous payment or overpayment to my account(s) by withdrawing funds in the amount of the excess payment. This authorization remains in effect until RANDCOL, LLC has received written authorization from me of its termination or change. Employee Signature: Date: NOTE: If your joint account requires both account holders to sign checks or authorize payments, the joint account holder must indicate their agreement with the above terms by signing below: Financial Institution/Account Number(s): Account 1: Account 2: Name of Joint Account Holder: Signature of Joint Account Holder: Date: Account Information Form for Account 1 Complete only this form for Account 1 if you want all of your pay deposited into a single account. If you want your pay per pay period deposited into two accounts, complete both this form for Account 1 and the form for Account 2. Account Type ( Checking ( Savings (Select one) Name of Financial Institution: Address of Financial Institution:  Telephone Number for Financial Institution: Percentage or Amount per Pay Period to Deposit for this Account: (examples: 100%; $350) (Use when pay is split between two accounts) Confirm Account 1:  Company Use OnlyBank/ABA Number: Account Information Form for Account 2 Complete this form in addition to the form for Account 1 if you want your pay per pay period deposited into two accounts. Do not complete this form if you want all of your pay deposited into a single account. Account Type ( Checking ( Savings (Select one) Name of Financial Institution: Address of Financial Institution:  Telephone Number for Financial Institution: Percentage or Amount per Pay Period to Deposit for this Account: (examples: 100%; $350) (Use when pay is split between two accounts) Confirm Account 2:  Company Use OnlyBank/ABA Number:     Confidential Information Direct Deposit Authorization Form Page  PAGE 1 of  NUMPAGES 3 Routing Number Account Number Routing Number Account Number Please print City, State, and Zip Code Street Address Routing Number Account Number City, State, and Zip Code Street Address Routing Number Account Number !"#$%3{  * + @ A G H J O Q e m n 3 4 ? @ C G R U W Y w y ʽ{{{{{n{{{{{hAhb5B*phhAB*phhbhb5B*\phhb5B*\phjho{UmHnHuhbB*phhbhbB*phhbhb5B*phhbhpB*ph hbhbhb5CJ\aJh4f5CJ\aJhbhb5CJ\aJ+#$68 * @ H I J 3 @ A B C S T U V W y z 1$7$8$H$gd#H 1$7$8$H$gdb 1$7$8$H$gdby z { 7 8 C L d e j v x zrrrrrzaRh! yh! yB*CJaJph h! yh! y5B*CJaJphhB*phh! y5B*\phh! yh! y5CJ\aJh5B*CJ\aJph#h! yh! y5B*CJ\aJphhAh! yB*phhbh! yB*phh#HB*phhbh#HB*phhbhAB*phjho{UmHnHuhAB*ph  : ; = @ A C q +,- 1$7$8$H$gdb 1$7$8$H$gd! y 1$7$8$H$gd#H     7 8 = > C D N U q r ޿޳޿޳޿޿ާ޿ykZ h#Hh#H6B*CJaJphh#H6B*CJaJph hmchmc6B*CJaJph hmchmc6B*CJaJphhmcB*CJaJphh#HB*CJaJphh! yB*CJaJphjho{UmHnHu h#Hh! y6B*CJaJphh! yh! yB*CJaJph# jqh! yh! yB*CJaJph+-./?QSTjs{|}~Ŵ֝}n\nNC\8h5B*\phh5CJ\aJh! yh5CJ\aJ#h! yh5B*CJ\aJphh5B*CJ\aJphhB*CJaJph&hh! y56B*CJ\aJphh! yh! yB*CJaJphh#HB*ph hh#H5B*CJaJph hhmc5B*CJaJphjho{UmHnHuh#HB*CJaJphh#Hh! yB*CJaJph-RS}~PQ^|1$7$8$H$gd 1$7$8$H$gd~NOPQ^_`opyefôwwwwf hmch6B*CJaJphhB*CJaJphjho{UmHnHu h#Hh6B*CJaJph# jqh! yhB*CJaJphh! yhB*CJaJph h! yh5B*CJaJphh5B*\phhh>*B*phhbhB*phhB*ph"f{| -k\TPTPTPTPH=hhCJaJhh5ho{jho{UhhBL)B*CJaJph&hh56B*CJ\aJphh! yhB*CJaJphhB*ph hh5B*CJaJphjho{UmHnHuhB*CJaJphh#HhB*CJaJph h#Hh6B*CJaJphh6B*CJaJph hmch6B*CJaJph QRSbcrs 1$7$8$H$gd! y 1$7$8$H$gdA 1$7$8$H$gd1k 1$7$8$H$gdw $ $a$gd $xgd-./45;<=>BCMNOPQSbcqrsѵѵѩuguuh#Hh! y6mHnHu h#Hh! y6B*CJaJphh#HhA6mHnHu h#HhA6B*CJaJphho{hhBL)CJ\aJhaK0JCJaJmHnHuhh0JCJaJ!jhh0JCJUaJhhCJaJhCJaJhhBL)CJaJ!&'67891$7$8$H$ 1$7$8$H$gd 1$7$8$H$gd#H 1$7$8$H$gd! y 1$7$8$H$gd&'5689̾hhBL)B*CJaJphh#Hh6mHnHu h#Hh6B*CJaJphh#Hh#H6mHnHuho{ h#Hh#H6B*CJaJph8 00P/ =!"#$% hDp^ 666666666vvvvvvvvv666666>6666666666666666666666666666666666666666666666666hH6666666666666666666666666666666666666666666666666666666666666666662 0@P`p2( 0@P`p 0@P`p 0@P`p 0@P`p 0@P`p 0@P`p8XV~_HmH nH sH tH @`@ NormalCJ_HaJmH sH tH DA`D 0Default Paragraph FontRiR 0 Table Normal4 l4a (k ( 0No List 44 BL)0Header  !6/6 0 Header CharCJaJ4 4 BL)0Footer  !6/!6 0 Footer CharCJaJ| 3| p0 Table Grid7:V0 dCJaJHBH b0 Balloon TextCJOJQJ^JaJN/QN 0Balloon Text CharCJOJQJ^JaJ2)@a2 0 Page Number^JPK![Content_Types].xmlj0Eжr(΢Iw},-j4 wP-t#bΙ{UTU^hd}㨫)*1P' ^W0)T9<l#$yi};~@(Hu* Dנz/0ǰ $ X3aZ,D0j~3߶b~i>3\`?/[G\!-Rk.sԻ..a濭?PK!֧6 _rels/.relsj0 }Q%v/C/}(h"O = C?hv=Ʌ%[xp{۵_Pѣ<1H0ORBdJE4b$q_6LR7`0̞O,En7Lib/SeеPK!kytheme/theme/themeManager.xml M @}w7c(EbˮCAǠҟ7՛K Y, e.|,H,lxɴIsQ}#Ր ֵ+!,^$j=GW)E+& 8PK!Ptheme/theme/theme1.xmlYOo6w toc'vuر-MniP@I}úama[إ4:lЯGRX^6؊>$ !)O^rC$y@/yH*񄴽)޵߻UDb`}"qۋJחX^)I`nEp)liV[]1M<OP6r=zgbIguSebORD۫qu gZo~ٺlAplxpT0+[}`jzAV2Fi@qv֬5\|ʜ̭NleXdsjcs7f W+Ն7`g ȘJj|h(KD- dXiJ؇(x$( :;˹! I_TS 1?E??ZBΪmU/?~xY'y5g&΋/ɋ>GMGeD3Vq%'#q$8K)fw9:ĵ x}rxwr:\TZaG*y8IjbRc|XŻǿI u3KGnD1NIBs RuK>V.EL+M2#'fi ~V vl{u8zH *:(W☕ ~JTe\O*tHGHY}KNP*ݾ˦TѼ9/#A7qZ$*c?qUnwN%Oi4 =3ڗP 1Pm \\9Mؓ2aD];Yt\[x]}Wr|]g- eW )6-rCSj id DЇAΜIqbJ#x꺃 6k#ASh&ʌt(Q%p%m&]caSl=X\P1Mh9MVdDAaVB[݈fJíP|8 քAV^f Hn- "d>znNJ ة>b&2vKyϼD:,AGm\nziÙ.uχYC6OMf3or$5NHT[XF64T,ќM0E)`#5XY`פ;%1U٥m;R>QD DcpU'&LE/pm%]8firS4d 7y\`JnίI R3U~7+׸#m qBiDi*L69mY&iHE=(K&N!V.KeLDĕ{D vEꦚdeNƟe(MN9ߜR6&3(a/DUz<{ˊYȳV)9Z[4^n5!J?Q3eBoCM m<.vpIYfZY_p[=al-Y}Nc͙ŋ4vfavl'SA8|*u{-ߟ0%M07%<ҍPK! ѐ'theme/theme/_rels/themeManager.xml.relsM 0wooӺ&݈Э5 6?$Q ,.aic21h:qm@RN;d`o7gK(M&$R(.1r'JЊT8V"AȻHu}|$b{P8g/]QAsم(#L[PK-![Content_Types].xmlPK-!֧6 +_rels/.relsPK-!kytheme/theme/themeManager.xmlPK-!Ptheme/theme/theme1.xmlPK-! ѐ' theme/theme/_rels/themeManager.xml.relsPK]  0@Niy9     '( 0@Niy 9 . kkkny ~f-9  -9 MTV[fhn!8*+@l** (  bB  S D#" ?bB  S D#" ?bB  S D#" ? f  8&L#' S"?hB  S D" H&,H&  c $ c"$`? D&'   c $ c"$`?O8&1 ' hB  S D"G&L#G&bB   S D#" ?   c $ s"*`??    c $ s"*`?? bB   S D#" ?bB  S D#" ? bB  S D#" ?   c $ s"*`?? bB  S D#" ? bB  S D#" ?  c $c"$??    c $c"$??  bB  S D#" ?bB  S D#" ?bB  S D#" ?t  8&L#'  S"?hB  S D" H&,H&  c $ c"$`? D&'   c $  c"$`?O8&1 '  hB  S D"G&L#G&bB  S D#" ?bB  S D#" ?bB ! S D#" ?  c $ c"$??     c $  c"$??  bB " S D#" ?bB # S D#" ?bB $ S D#" ?t  8&L#' % S"?hB & S D" H&,H& ' c $  c"$`? D&'   ( c $  c"$`?O8&1 '  hB ) S D"G&L#G&bB * S D#" ?B S  ?*@3CDEFWXz=Cq-9 tt,ht wE \t@ /t Ot Pt@ Pt@ t5 5 tt CtvZT,%TF FtF wFwt`Jt-t!LtBHt CtvZT ,%T!F Ft"F wFwt#`Jt$-t%!Lt*BHt4 > B P : 4 > B P : 4 > B P : DW4fwBL)AMA#Hbabmc1kwnp\q! yo{aK=d@(9 `@UnknownG*Ax Times New Roman5Symbol3. *Cx Arial;Wingdings5. *[`)TahomaACambria Math"hFFѦTT!xx2?BL)2!xx!Direct Deposit Authorization FormRANDCOLRANDCOLOh+'0`    ( 4@HPX$Direct Deposit Authorization FormRANDCOLNormalRANDCOL2Microsoft Office Word@F#@@SA@SAT՜.+,0  hp|   #Direct Deposit Authorization Form Title  !"#$%&'()*+,-./012356789:;=>?@ABCFRoot Entry FTAH1Table6WordDocument:.SummaryInformation(4DocumentSummaryInformation8<CompObjy  F'Microsoft Office Word 97-2003 Document MSWordDocWord.Document.89qRoot Entry F<7PN@1Table6WordDocument:.SummaryInformation(4  !"#$%&'()*+,-./012356789:;ML DocumentSummaryInformation8CompObjy  F'Microsoft Office Word 97-2003 Document MSWordDocWord.Document.89q՜.+,D՜.+,P  hp|   #Direct Deposit Authorization Form Title4 $,