EMPLOYER DIRECT DEPOSIT FORM
Section A. Your Personal Information (all elds required)
Section B. Direct Deposit Instructions | Discover Bank Routing Number: 031100649
Section C. Authorization
(all elds required)
By signing below, I authorize _________________________ (employer name) to initiate credit entries and, if necessary, to initiate
any debit entries and adjustments to correct any erroneous credit entries to my Discover bank account(s). I understand that this
authorization will remain in full aect until the company named here has received written notication from me of its termination in
such time as to aord the company and depository a reasonable opportunity to act.
First Name
Discover Bank Account (provide details for at least one Discover Bank Account)
Discover Bank Account
Discover Bank Account
Checking
Checking
Checking
Savings
Savings
Savings
Money Market
Money Market
Money Market
Account Number — No dashes
Account Number — No dashes
Account Number — No dashes
* This authorization form is valid only to initiate a direct deposit of funds to a Discover Bank deposit account. Participation in direct deposit is
contingent upon your employer oering the service and your eligibility to participate.
Account Holder Signature (Print and Sign)
Date
MM DD YYYY
Entire Net Pay
Entire Net Pay
Entire Net Pay
_____% Net Pay
_____% Net Pay
_____% Net Pay
Specic Amount $_________
Specic Amount $_________
Specic Amount $_________
Last Name Social Security Number or Employee ID
Account Holder Name (Please Print)
Did you know you can deposit your paychecks directly to your Discover bank account?* It’s one more way we make banking easier.
To sign up, you will need to ll out this form and return it to your employer.
A few things to keep in mind:
• It may take some time for your employer to set up your direct deposit, so please provide this form to them
as soon as possible
• Until your direct deposit is set up, your employer may still give you paper checks
• You can split your direct deposit between your Discover bank accounts, if desired
To complete this form, please:
1. Fill out your name and provide your Social Security Number or Employee ID
2. Select the type of Discover bank account(s) where you want to receive your direct deposit and whether you want the full amount,
a % of the amount, or a specic amount deposited in the single bank account, or split between multiple bank accounts
3. Print the form, sign it, and return the form to your employer – don’t forget to sign
©2020 Discover Bank, Member FDIC
