MARC Direct Deposit Submission Form

MARC, Inc. of Manchester

Direct Deposit Form
I authorize MARC, Inc. to deposit my paycheck as follows:
Account #
Bank Name
ABA Routing #
I also authorize MARC, Inc. to resere any deposits that are made in error into the above accounts.
Name

First Name Last Name
Signature of Parent or Guardian

Clear
Date

Month Day Year
Date
Should be Empty:

MARC, Inc. of Manchester