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The document is a Direct Deposit Authorization Form provided by TD Bank, detailing the steps to enroll in direct deposit for federal government benefits and payroll compensation. It outlines the necessary information required for each type of enrollment, including personal details and bank account information. The form must be completed and submitted to the employer's payroll representative for payroll compensation or through godirect.gov for federal benefits.

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33 views1 page

Dda en

The document is a Direct Deposit Authorization Form provided by TD Bank, detailing the steps to enroll in direct deposit for federal government benefits and payroll compensation. It outlines the necessary information required for each type of enrollment, including personal details and bank account information. The form must be completed and submitted to the employer's payroll representative for payroll compensation or through godirect.gov for federal benefits.

Uploaded by

stpaullive1
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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Direct Deposit Authorization Form

TD Bank makes setting up direct deposit easy with this convenient, pre-filled form. There are two types of
direct deposit enrollment available: Federal Government Benefit Compensation and Payroll Compensation.
Steps to enroll for each are outlined below.

1. Federal Government Benefit Compensation:

To sign up for direct deposit of your federal benefit payments such as Social Security,
SSI or VA Compensation and Pension Payment, visit godirect.gov.

You’ll need your:


• Social security number or claim number • TD Bank’s routing transit number:
• 12-digit federal benefit check number • TD Bank account number:
• Amount of most recent federal benefit check • Type of account (checking or savings):

2. Payroll Compensation
Complete and sign this direct deposit form and give it to your employer’s payroll representative – it’s that easy!

Employee name and address:

Employee phone number:

Employee ID:
(if applicable)
Employee social security number:

Please begin directly depositing my payroll and/or dividend or annuity check into my account at TD Bank.

Direct deposit the following:


o Total net check amount
o The set amount of $_____________________________ of my net check each period.

Bank name: TD Bank, N.A.


Address: 32 Chestnut St.
P.O. Box 1377
Lewiston, ME 04243-1377
TD Bank routing transit number:
TD Bank account number:
Type of account: o Checking o Savings

Employee signature Date

Member FDIC, © 2022, TD Bank, N.A. and/or its affiliates. | All Rights Reserved. 11440C-CHK (1022)

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