Kaya HR - Payroll Services, Human Resources, Worker's Comp & More

Name *

Email *

(Your direct deposit stub will be emailed to this address each payday)

Phone *

Direct Deposit 1 *

Checking Account
Savings Account

Name of Financial Institution *

Would you like your earnings deposited in one account or split between two? *

Full Paycheck Amount
Two Accounts

If there are two bank accounts you'd like us to deposit your earnings into, please complete Direct Deposit 2.

Amount to Deposit: Account 1 *

Voided Check Upload

Drag & Drop Files, Choose Files to Upload You can upload up to 2 files.

Please provide documentation from your bank with pre-printed routing and account numbers. If you don’t have documentation, please double-check your routing and account number as an incorrect entry may result in a delay in payment.

Routing Number *

Confirm Routing Number *

Account Number *

Confirm Account Number *

Direct Deposit 2 *

Checking Account
Savings Account

Name of Financial Institution *

Amount to Deposit: Account 2 *

Voided Check Upload

Drag & Drop Files, Choose Files to Upload You can upload up to 2 files.

Please provide documentation from your bank with pre-printed routing and account numbers. If you don’t have documentation, please double-check your routing and account number as an incorrect entry may result in a delay in payment.

Routing Number *

Confirm Routing Number *

Account Number *

Confirm Account Number *

Authorization *

I authorize Kaya HR to direct deposit my paycheck funds into the account(s) listed above. I also understand Kaya HR is not liable for any delays due to errors submitted on this form.

Type Full Name *

Date *

Direct Deposit Form

Portland Office

Eugene Office