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Direct Deposit
Authorization Form
TD Bank makes set
ting up direct deposit easy with this convenient, pre-illed form. There are two types of
direct deposit enrollment available: Federal Government Beneit Compensation and Payroll Compensation.
Steps to enroll for each are outlined below.
1. Fe
deral Government Beneit Compensation:
To sign up for direct deposit of your federal beneit payments such as Social Security,
SSI or VA Compensation and Pension Payment, visit godirect.gov .
Yo
u’ll need your:
• S
ocial security number or claim number
• 12-digit federal beneit check number
• Amount of most recent federal beneit check
• TD Bank’s routing transit number:
• TD Bank account number:
• Type of account (checking or savings):
2. Pa
yroll Compensation
C
omplete and sign this direct deposit form and give it to your employer’s payroll representative – it’s that easy!
Employee name and address:
E
mployee phone number:
E
mployee ID:
(if applicable)
E
mployee social security number:
P
lease begin directly depositing my payroll and/or dividend or annuity check into my account at TD Bank.
D
irect deposit the following:
To
tal net check amount
T
he set amount of
o
f my net check each period.
Bank name: TD Bank, N.A.
Ad
dress: 32 Chestnut St.
P.O. Box 1377
Lewiston, ME 042431377
T
D Bank routing transit number:
T
D Bank account number:
Ty
pe of account:
C
hecking
S
avings
E
mployee signature
D
ate
M
ember FDIC, © 2022, TD Bank, N.A. and/or its afiliates. | All Rights Reserved. 1
1440CCHK (1022)
