{"id":593,"date":"2014-09-08T13:59:23","date_gmt":"2014-09-08T13:59:23","guid":{"rendered":"https:\/\/www.avacon.org\/blog\/?page_id=593"},"modified":"2014-09-08T14:03:39","modified_gmt":"2014-09-08T14:03:39","slug":"direct-deposit-authorization-form","status":"publish","type":"page","link":"https:\/\/www.avacon.org\/blog\/documents\/direct-deposit-authorization-form\/","title":{"rendered":"Direct Deposit Authorization Form"},"content":{"rendered":"<h1>Direct Deposit Authorization Form<\/h1>\n<p>By electronically signing this form, I hereby authorize <strong>AVACON, INC.<\/strong> to initiate credit, and if necessary, debit entries and adjustments for any credit entries in error to my Checking or Savings account as indicated below, and the depository Financial Institution named below, and to credit or debit the same from such account.<\/p>\n<p>Further, I agree not to hold <strong>AVACON, INC<\/strong>. responsible for any delay or loss of funds due to incorrect or incomplete information supplied by me or by my Financial Institution or due to an error on the part of my Financial Institution in depositing funds to my account.<\/p>\n<p>I acknowledge that this authorization will remain in full force and effect until I have cancelled this authorization in writing and in such a manner as to afford <strong>AVACON, INC.<\/strong> and the named Financial Institution a reasonable opportunity to act upon the cancellation.<\/p>\n<p>I acknowledge that the origination of the ACH transactions to my account must comply with the provisions of U.S. law.<\/p>\n<h3>Sample Check Image<\/h3>\n<p><img loading=\"lazy\" decoding=\"async\" class=\"alignnone\" src=\"https:\/\/avacon.org\/docs\/check_sample.jpg\" alt=\"\" width=\"550\" height=\"309\" \/><\/p>\n<h2><\/h2>\n<h2>Direct Deposit Authorization Form<\/h2>\n<div class=\"frm_forms  with_frm_style frm_style_formidable-style\" id=\"frm_form_26_container\" >\n<form enctype=\"multipart\/form-data\" method=\"post\" class=\"frm-show-form \" id=\"form_ly2koy\" >\n<div class=\"frm_form_fields \">\n<fieldset>\n\r\n<div class=\"frm_fields_container\">\n<input type=\"hidden\" name=\"frm_action\" value=\"create\" \/>\n<input type=\"hidden\" name=\"form_id\" value=\"26\" \/>\n<input type=\"hidden\" name=\"frm_hide_fields_26\" id=\"frm_hide_fields_26\" value=\"\" \/>\n<input type=\"hidden\" name=\"form_key\" value=\"ly2koy\" \/>\n<input type=\"hidden\" name=\"item_meta[0]\" value=\"\" \/>\n<input type=\"hidden\" id=\"frm_submit_entry_26\" name=\"frm_submit_entry_26\" value=\"797c600ece\" \/><input type=\"hidden\" name=\"_wp_http_referer\" value=\"\/blog\/wp-json\/wp\/v2\/pages\/593\" \/><div id=\"frm_field_679_container\" class=\"frm_form_field form-field  frm_required_field frm_top_container\">\r\n    <label for=\"field_cps3g3\" class=\"frm_primary_label\">Employee Full Name\r\n        <span class=\"frm_required\">*<\/span>\r\n    <\/label>\r\n<div id=\"frm_desc_field_cps3g3\" class=\"frm_description\">Enter your First and Last name as it appears on your bank account.<\/div>    \r\n<input type=\"text\" id=\"field_cps3g3\" name=\"item_meta[679]\" value=\"\"  data-reqmsg=\"Employee Full Name cannot be blank.\" aria-required=\"true\" data-invmsg=\"Employee Full Name is invalid\" aria-invalid=\"false\"   aria-describedby=\"frm_desc_field_cps3g3\"\/>\r\n        \r\n<\/div>\n<div id=\"frm_field_680_container\" class=\"frm_form_field form-field  frm_required_field frm_top_container vertical_radio\">\r\n    <label  class=\"frm_primary_label\">Account Type\r\n        <span class=\"frm_required\">*<\/span>\r\n    <\/label>\r\n  \r\n    <div class=\"frm_opt_container\">\t\t<div class=\"frm_radio\" id=\"frm_radio_680-0\">\t\t\t<label  for=\"field_fyr8w3-0\">\n\t\t\t\t\t<input type=\"radio\" name=\"item_meta[680]\" id=\"field_fyr8w3-0\" value=\"Checking\"\n\t\t data-reqmsg=\"Account Type cannot be blank.\" data-invmsg=\"Account Type is invalid\"   \/> Checking<\/label><\/div>\n\t\t<div class=\"frm_radio\" id=\"frm_radio_680-1\">\t\t\t<label  for=\"field_fyr8w3-1\">\n\t\t\t\t\t<input type=\"radio\" name=\"item_meta[680]\" id=\"field_fyr8w3-1\" value=\"Savings\"\n\t\t data-reqmsg=\"Account Type cannot be blank.\" data-invmsg=\"Account Type is invalid\"   \/> Savings<\/label><\/div>\n<\/div>\r\n  \r\n    \r\n<\/div>\n<div id=\"frm_field_681_container\" class=\"frm_form_field form-field  frm_required_field frm_top_container\">\r\n    <label for=\"field_i4lygn\" class=\"frm_primary_label\">Banking Institution Name\r\n        <span class=\"frm_required\">*<\/span>\r\n    <\/label>\r\n <div id=\"frm_desc_field_i4lygn\" class=\"frm_description\">Enter the name of your banking institution.<\/div>\r\n    <input type=\"text\" id=\"field_i4lygn\" name=\"item_meta[681]\" value=\"\"  data-reqmsg=\"Banking Institution Name cannot be blank.\" aria-required=\"true\" data-invmsg=\"Banking Institution Name is invalid\" aria-invalid=\"false\"   aria-describedby=\"frm_desc_field_i4lygn\"\/>\r\n   \r\n    \r\n<\/div>\n<div id=\"frm_field_682_container\" class=\"frm_form_field form-field  frm_required_field frm_top_container\">\r\n    <label for=\"field_y57h17\" class=\"frm_primary_label\">Bank ROUTING Number (ABA#)\r\n        <span class=\"frm_required\">*<\/span>\r\n    <\/label>\r\n <div id=\"frm_desc_field_y57h17\" class=\"frm_description\">Enter the Bank ROUTING Number (ABA#) from your check.  This is usually the FIRST string of digits printed on the bottom of your check.<\/div>\r\n    <input type=\"text\" id=\"field_y57h17\" name=\"item_meta[682]\" value=\"\"  data-reqmsg=\"Bank ROUTING Number (ABA#) cannot be blank.\" aria-required=\"true\" data-invmsg=\"Bank ROUTING Number (ABA#) is invalid\" aria-invalid=\"false\"   aria-describedby=\"frm_desc_field_y57h17\"\/>\r\n    \r\n<\/div>\n<div id=\"frm_field_683_container\" class=\"frm_form_field form-field  frm_required_field frm_top_container\">\r\n    <label for=\"field_98ckku\" class=\"frm_primary_label\">Bank ACCOUNT Number\r\n        <span class=\"frm_required\">*<\/span>\r\n    <\/label>\r\n <div id=\"frm_desc_field_98ckku\" class=\"frm_description\">Enter the Bank ACCOUNT Number from your check.  This is usually the SECOND string of numbers printed at the bottom of your check.<\/div>\r\n    <input type=\"text\" id=\"field_98ckku\" name=\"item_meta[683]\" value=\"\"  data-reqmsg=\"Bank ACCOUNT Number cannot be blank.\" aria-required=\"true\" data-invmsg=\"Bank ACCOUNT Number is invalid\" aria-invalid=\"false\"   aria-describedby=\"frm_desc_field_98ckku\"\/>\r\n    \r\n<\/div>\n<div id=\"frm_field_684_container\" class=\"frm_form_field form-field  frm_required_field frm_top_container\">\r\n    <label for=\"field_qumyez\" class=\"frm_primary_label\">Signature\r\n        <span class=\"frm_required\">*<\/span>\r\n    <\/label>\r\n <div id=\"frm_desc_field_qumyez\" class=\"frm_description\">By electronically signing this form, I hereby authorize AVACON, INC. to initiate credit, and if necessary, debit entries and adjustments for any credit entries in error to my Checking or Savings account as indicated above, and the depository Financial Institution named above, and to credit or debit the same from such account.  Further, I agree not to hold AVACON, INC. responsible for any delay or loss of funds due to incorrect or incomplete information supplied by me or by my Financial Institution or due to an error on the part of my Financial Institution in depositing funds to my account.  I acknowledge that this authorization will remain in full force and effect until I have cancelled this authorization in writing and in such a manner as to afford AVACON, INC. and the named Financial Institution a reasonable opportunity to act upon the cancellation.  I acknowledge that the origination of the ACH transactions to my account must comply with the provisions of U.S. law.<\/div>\r\n    <input type=\"text\" id=\"field_qumyez\" name=\"item_meta[684]\" value=\"\"  data-reqmsg=\"Signature cannot be blank.\" aria-required=\"true\" data-invmsg=\"Signature is invalid\" aria-invalid=\"false\"   aria-describedby=\"frm_desc_field_qumyez\"\/>\r\n    \r\n<\/div>\n<div id=\"frm_field_685_container\" class=\"frm_form_field form-field  frm_required_field frm_top_container\">\r\n    <label for=\"field_hlkqp6\" class=\"frm_primary_label\">Date\r\n        <span class=\"frm_required\">*<\/span>\r\n    <\/label>\r\n    <input type=\"text\" id=\"field_hlkqp6\" name=\"item_meta[685]\" value=\"[date]\"  style=\"width:90px\" maxlength=\"10\" data-frmval=\"[date]\" data-reqmsg=\"Date cannot be blank.\" aria-required=\"true\" data-invmsg=\"Date is invalid\" class=\"auto_width\" aria-invalid=\"false\"  \/>\r\n    \r\n    \r\n<\/div>\n\t<input type=\"hidden\" name=\"item_key\" value=\"\" \/>\n\t\t\t<div id=\"frm_field_703_container\">\n\t\t\t<label for=\"field_68wax\" >\n\t\t\t\tIf you are human, leave this field blank.\t\t\t<\/label>\n\t\t\t<input  id=\"field_68wax\" type=\"text\" class=\"frm_form_field form-field frm_verify\" name=\"item_meta[703]\" value=\"\"  \/>\n\t\t<\/div>\n\t\t<input name=\"frm_state\" type=\"hidden\" value=\"as7lhoZmdL4RjPK9tgyaKTwVQ8vxGrlTsuAyoHg3pdY=\" \/><div class=\"frm_submit\">\r\n\r\n<input type=\"submit\" value=\"Submit\"  \/>\r\n<img decoding=\"async\" class=\"frm_ajax_loading\" src=\"https:\/\/www.avacon.org\/blog\/wp-content\/plugins\/formidable\/images\/ajax_loader.gif\" alt=\"Sending\" style=\"visibility:hidden;\" \/>\r\n\r\n<\/div><\/div>\n<\/fieldset>\n<\/div>\n\n<p style=\"display: none !important;\" class=\"akismet-fields-container\" data-prefix=\"ak_\"><label>&#916;<textarea name=\"ak_hp_textarea\" cols=\"45\" rows=\"8\" maxlength=\"100\"><\/textarea><\/label><input type=\"hidden\" id=\"ak_js_1\" name=\"ak_js\" value=\"67\"\/><script type=\"text\/javascript\">\n\/* <![CDATA[ *\/\ndocument.getElementById( \"ak_js_1\" ).setAttribute( \"value\", ( new Date() ).getTime() );\n\/* ]]> *\/\n<\/script>\n<\/p><\/form>\n<\/div>\n\n<p>&nbsp;<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Direct Deposit Authorization Form By electronically signing this form, I hereby authorize AVACON, INC. to initiate credit, and if necessary, debit entries and adjustments for any credit entries in error to my Checking or Savings account as indicated below, and the depository Financial Institution named below, and to credit or debit the same from such [&hellip;]<\/p>\n","protected":false},"author":2,"featured_media":0,"parent":9,"menu_order":0,"comment_status":"closed","ping_status":"open","template":"","meta":{"footnotes":""},"class_list":["post-593","page","type-page","status-publish","hentry"],"jetpack_sharing_enabled":true,"_links":{"self":[{"href":"https:\/\/www.avacon.org\/blog\/wp-json\/wp\/v2\/pages\/593","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.avacon.org\/blog\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/www.avacon.org\/blog\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/www.avacon.org\/blog\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/www.avacon.org\/blog\/wp-json\/wp\/v2\/comments?post=593"}],"version-history":[{"count":0,"href":"https:\/\/www.avacon.org\/blog\/wp-json\/wp\/v2\/pages\/593\/revisions"}],"up":[{"embeddable":true,"href":"https:\/\/www.avacon.org\/blog\/wp-json\/wp\/v2\/pages\/9"}],"wp:attachment":[{"href":"https:\/\/www.avacon.org\/blog\/wp-json\/wp\/v2\/media?parent=593"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}