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Save Time with Direct Deposit

Complete this form, take it to your employer’s payroll department and get your paychecks deposited directly into
your account.
DAVID HANNAGAN
Name
7322 E PATRICIA ST
Address
PORT ORCHARD WA 98366-8424
City State ZIP code

If you wish to set up or transfer direct deposit of income from investments, pension/retirement plans, interest or
dividends, complete the below fields and mail it to your company.

Taco Bell
Company name

532-98-0329
Account # or Customer ID # Social Security number (XXX-XX-XXX)

Port Orchard WA
Company address City State ZIP code

Account type: X Checking Savings

325070760
Chase routing number
878746590
Chase account number

I authorize ___________________ (name of business) and my bank to automatically deposit my paycheck into my
account listed above (this includes my authorization to correct entries made in error). This authorization will remain
in effect until I give written notice to cancel it.

Customer signature Date

Member FDIC JPMorgan Chase & Co. 2018

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