DiRECT DEPOSiT AGREEMENT FORM

Direct Deposit Agreement Form
I hereby authorize Tower Legal Staffing, Inc. to initiate automatic deposits to my
account at the financial institution named below. I also authorize Tower Legal
Staffing, Inc. or its designated agent to make withdrawals from this account in
the event that credit entry is made in error.
Further, I agree not to hold Tower Legal Staffing, Inc. responsible for any
delay or loss of funds due to incorrect or incomplete information supplied by
me or my financial institution, or due to an error on the part of my financial
institution in depositing funds to my account.
This agreement will remain in effect until Tower Legal Staffing, Inc. receives a
written notice of cancellation from me or my financial institution, or until I
submit a new direct deposit form to the Payroll Department.
Name as it Appears on your Account:
Name of Financial Institution:
Routing Number:
Account Number:
Checking 
Authorized Signature (Primary):
Date:
Authorized Signature (Joint):
Date:
Savings 
Please attach a voided check or deposit slip and return this form to the
Payroll Department.