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Direct Deposit Enrollment Form: Spruce

This document is an enrollment form for direct deposit into a Spruce spending account. It collects the user's name, spending account number, routing number, bank information, and voided check for verification. The user authorizes their employer to deposit funds electronically into their account until written notice is provided.

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dolly
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297 views

Direct Deposit Enrollment Form: Spruce

This document is an enrollment form for direct deposit into a Spruce spending account. It collects the user's name, spending account number, routing number, bank information, and voided check for verification. The user authorizes their employer to deposit funds electronically into their account until written notice is provided.

Uploaded by

dolly
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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Spruce

Direct Deposit Enrollment Form


Name Spending Account Number Routing Number

ERIC CAMPBELL 322101681003 091409843

Bank Recurring Direct Deposit Amount

MetaBank®, N.A. Entire Check

Customer Support ________% of each check


(855) 977-7823
$________ of each check

Voided Check

ERIC CAMPBELL
1428 Wilburn Dr Date: ________________
Oklahoma City, OK 73127

Pay to ____________________________________________________
the $
order of
________________________________________________________ Dollars

091409843 322101681003
________________ ____________________
Routing Number Direct Deposit Number

Authorization
I wish to have my pay/benefits directly deposited into my Spruce Spending Account. I authorize my
employer or benefits provider to initiate electronic credit entries and if necessary, to initiate any debit
entries and adjustments to correct previous credit errors to my Spruce Spending Account. This authority
will remain in effect until I notify my employer or benefits provider in writing or as otherwise specified by
my employer or benefits provider.

Signature__________________________________________________ Date_____________________

Please check with your employer or benefits provider as they may not offer direct deposit or partial direct deposit.

The SpruceSM Spending Account is established at, and the Spruce debit card is issued by, MetaBank®, N.A., Member FDIC, pursuant to license by Mastercard International Incorporated.
Mastercard® and the circles design are registered trademarks of Mastercard International Incorporated.

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