Direct deposit form

1. Let your employer or other organization that pays you know that you'd like to add your paycheck
to PayPal with Direct Deposit.

2. Verify that your personal information below is correct.

3. Choose the amount you want to add to PayPal from each check, then sign and date the form. Send
it to your employer to sign up. Note: Not all employers allow you to add less than the entire
amount.

Account type
Checking

PayPal assigned account number ABA routing and transit number

22113516023514783 121000248

Financial Institution Name and Address

Wells Fargo Bank, N.A.
101 N. Phillips Avenue
Sioux Falls, SD 57104
Your money will be held in a custodial account at Wells Fargo Bank, N.A.

Account Holder's Name

Marshall Tanner

Deposit (check one)

Entire paycheck

Percent of paycheck

Amount

Signature Date

I authorize my employer or other organization that pays me to add my checks to PayPal with
Direct Deposit, as stated above.