Fillable Printable Direct Deposit Request - Alabama

Direct Deposit Request - Alabama

FRMS-15

Rev. 04/1999

STATE OF ALABAM A

DIRECT DEPOSIT REQUEST

The State of Alabama is requested to electronically transfer my salary to the bank or

financial institution listed below.

Attach a copy of the Employee’s voided check or deposit slip.

Name of Financial Institution:

Account Type: Checking

(or) Savings (Check 1 box only)

Account Number:

Bank Routing Number:

Type/Print Employee’s Name as on Payroll Records.

Employee’s Social Secu rity Number

Employee’s HOME Mailing Address (Street)

City, State, and Zip Code of Employee’s Hom e Mailing Address

Employee’s Departme nt or Agency

Employee’s Home Telep hone Number Work Teleph one Number

____________________________ _____________________________

Signature of Employee Date