Direct Deposit Change Form

Folks Home Care · Employee Resources

Tell us where you'd like your paycheck deposited. It only takes a couple of minutes.

For your protection: our office will call you to verify this request before any change is made to your direct deposit.

1Employee

Employee Name *

Please enter your full name.

Date *

Please enter today's date.

Phone Number *

Please enter a 10-digit phone number.

We'll call this number to verify the change.

Email Address (optional)

Please enter a valid email address or leave it blank.

2What would you like to do?

Change my bank accountReplace my current direct deposit Set up direct depositFirst time using direct deposit

Please choose one option.

3New Bank Account
Your entire net pay will be deposited into this account.

Bank Name *

Please enter your bank name.

Account Type *

Checking Savings

Please choose Checking or Savings.

Routing Number *

Please check your routing number. It should be 9 digits.

✓ Valid routing number

Account Number *

Please enter your account number (4 to 17 digits).

Confirm Account Number *

The account numbers do not match.

✓ Account numbers match

You can find these numbers at the bottom of a check: the routing number (9 digits) comes first, then your account number. You can also find them in your bank's app.

4Authorization & Signature

Sign below *

×Draw your signature here

Use your mouse, finger or stylus.

Please sign the form.

I authorize Folks Home Care LLC to deposit my pay into the account listed above and, if needed, to correct any amount deposited in error. This authorization stays in effect until I notify Folks Home Care in writing.

Please check this box to authorize the change.

Your banking details are sent securely to our office only and are not saved on this website.

+1 651-300-4440

info@folkshomecare.com