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Payment Authorization Form

  • Two Convenient Options

    To receive your pay via direct deposit or to enroll for the Focus Card, please fill out your bank account information in the section provided below. (You may choose either direct deposit or the Focus Card). If choosing direct deposit, please attach a voided check or copy of check here. Do not attach a deposit slip, the routing number is not always correct.

  • Direct DepositFocus Card
  • Direct Deposit

    By choosing traditional direct deposit, your pay will be deposited directly into your checking or savings account each payday. Fill out your account information below:

    • Focus Card

      With the Focus Card, your pay will be deposited onto a prepaid Visa card. Your card can be used anywhere Visa debit cards are accepted worldwide. It's not a credit card and there is no cost to enroll.

    • Important Information About Procedures For Opening A New Account

      To help the government fight the funding of terrorism and money laundering activities, Federal law requires all financial institutions to obtain, verify, and record information that identifies each person who opens an account. What this means for you: when you open an account, we will ask for your name, address, date of birth, and other information that will allow us to identify you. We may also ask to see your driver's license or other identifying documents.

      I hearby authorize my employer to initiate credit entries (deposits) and to initiate, if necessary, debt entries and adjustments for any credit entries in error to my Focus Card or bank account. This authorization will remain in effect until cancelled by me with written notification to my employer.