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Direct Deposit Agreement/Acuerdo de Deposito Directo

First name/Primero Nombre*

Last name/Apellido*

Phone/Numero de Telefono*

Social Security/Seguro Social*

Email/Correo electrónico*

Bank Name/Nombre del Banco*

Routing Number/Numero de Ruta*

Account Number/Numero de Cuenta*

Choose one of the following?/Elige Una De Las Siguientes?*

Checking/Cuenta de Cheque

Saving/Cuenta de Ahorros

Choose on of the following?/Elige Una De Las Siguientes?*

New Form/ Forma Nueva

Updated Form/Actualizando Forma

Are you currently working for JPA Workforce?/Esta actualnente trabajando para JPA Workforce?*

Upload the Direct Deposit form/ Subir el formulario de Depósito Directo*

Signature/Firma*

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