Direct_Deposit

Employer Name: Excel Gymnastics training center, inc.
Employer i.d. 13-64093380
I hereby authorize my employer DBA EXCEL GYMNASTICS to initiate credit entries and to initiate if necessary, debit entries and adjustments for any credit entries in error to my (our) account or accounts listed below.

Name of bank, savings & loan or credit union:(Required)

Type of account:(Required)

Account Number:(Required)

Routing and Transit Number:(Required)

Type of account:

Account Number:

Routing and Transit Number:

This authority is to remain in full force and effect until Rob Brown/Excel Gymnastics has received written notification from me (or either of us) of its termination in such time and manner as to afford Rob Brown/Excel Gymnastics a reasonable opportunity to act on it.

Employee Name:(Required)

Cell Phone(Required)

(XXX) XXX-XXXX

Employee Social Security Number:(Required)

XXX-XX-XXXX

Date(Required)

Direct Deposit Form