Direct Deposit Enrollment Form
I authorize to initiate credit entries, and, if necessary, to initiate any debit
entries to correct a previous credit error, to my M1 Spend account at Lincoln Savings Bank. In the event
that employer/third party deposits funds erronously into my account, I authorize employer/third party to
debit my account for an amount not to exceed the original amount of the erroneous credit. This
authorization is to remain in full force and effect until Lincoln Savings Bank has received written notice
from me of its termination in such time and in such manner as to afford Lincoln Savings Bank reasonable
opportunity to act on it.
Please fill out this voided check with your name, address, and M1 Spend account number.
The image of this voided check may be provided to your employer or other payer for no other purpose except to set up direct
deposit to your M1 Spend account.
Payor name
M1 Spend account number
Name, Address, City, State ZIP
Date:
Name:
Phone support: 1-312-600-2883
Please deposit
of my deposit to this account.
$
%
Bank name: Lincoln Savings Bank
checking
073923033
Account type:
Routing number:
Account number:
Account details
Voided check
Amount:
Signature:
PAY TO THE
ORDER OF:
FOR
Lincoln Savings Bank - 508 Main Street, Reinbeck, IA 50669
$
VOID
click to sign
signature
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signature
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