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Direct Deposit Authorization

Employer Information

Name: Blue Prestige Inc

Address:
100 N Church St
Burlington NC 27217

Phone Number: 336-350-8375

Email: Hr@blueprestigeinc.com

Employee Information

Name:

Address:

Phone Number:

Email:

Financial Institution #1:

Bank Name:

Routing Number:

Account Number:

Type of Account: CheckingSaving

Amount to Deposit:
(Enter 0-100%)

Financial Institution #2 (Optional):

Bank Name:

Routing Number:

Account Number:

Type of Account: CheckingSaving

Amount to Deposit:
(Enter 0-100%)

Please upload a cancelled check for each account.

I authorize Blue Prestige Inc to deposit my weekly paycheck to the account(s) provided in this form and, if necessary, to adjust or reverse any payroll deposit entry to my account(s) in error. The authorization will remain in effect until I cancel or changed in writing and in such time as to afford Blue Prestige Inc, a reasonable opportunity to act on it.

Today's Date:

Leave this empty:

Your legal name

Your email address

Please Confirm full name and signature.

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Timestamp

Audit

June 27, 2021 4:17 pm EDT

Direct Deposit Authorization Uploaded by Laura Reyes - lreyes@blueprestigeinc.com IP 71.251.236.64

June 27, 2021 4:52 pm EDT

Document owner clients@jonroc.com has handed over this document to lreyes@blueprestigeinc.com 2021-06-27 16:52:19 - ::1