Notice to Applicant: Intuit will contact your bank to confirm your authority to initiate debits against the account indicated
on this form. Intuit will use the information on this page for processing changes to your Direct Deposit service and for no
other purpose. If you have questions, please visit www.payroll.intuit.com/support.
Instructions: Complete the applicant section only and fax to Intuit Payroll Services at 877.699.8996. We will notify you of
the status of your request by email.
To be completed by applicant company
Company information:
Company Federal Employer Identification number (EIN) Company name
Old financial institution Routing (ABA) number Old Bank Account Number
Bank account information (for new bank account to be debited):
Financial institution name Financial institution contact name
Financial institution contact telephone, fax number Business or individual(s) name on account
QuickBooks bank register name/Chart of Accounts Account type (checking/savings)
New financial institution routing (ABA) number New bank account number
To the financial I/We have applied for payroll services with Intuit Payroll Services and I/we authorize you to
institution: give answers to the questions below regarding my/our account. I/We authorize Intuit
Payroll Services to initiate ACH debits against the account above. I/We authorize Intuit
Payroll Services to confirm my/our authority by contacting you, the bank.
Signature of Principal 1 Soc Sec number Signature of Principal 2 (if applicable) Soc Sec number
Printed name Driver’s lic #, state Printed name (if applicable) Driver’s lic #, state
Date Date
Principal 1 email address/daytime phone number (to be used only for communicating status of this request)
To be completed by financial institution (for Intuit use only)
For the payroll account shown above:
Does the Federal Employer Identification number (EIN) or Social Security number (SSN) match the above info? Yes No
Is/are the individuals shown above authorized to sign checks/debits against the payroll account shown? Yes No
Does the company name shown above match the name on the payroll account shown? Yes No
Please provide contact information for your financial institution in case questions arise regarding this information:
Financial institution contact name Contact phone Contact email address
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Forms - SE-815 Bank Account Change Ver. SE-815-Bank_Account_Change-20140303
Direct Deposit Bank Account Change Form
Complete, print, sign and send completed form to: (fax) 877.699.8996 or SBPFCSOperations@intuit.com
Intuit QuickBooks Payroll
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