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

Name *

First

Last

I Work For *

Email *

Date of Birth *

Select Accounts (2 Max) *

Bank Account #1
Bank Account #2
Rapid PayCard (in addition to or in place of direct deposit)

*If you choose a dollar amount for your first deposit, the second deposit will be 100% remainder of your pay; if you chose a percentage for both, they must equal 100%

Bank Account #1 *

Choose One (Bank Account 1) *

Checking
Savings

Routing Number *

Account Number *

Enter % of Net Pay OR Dollar Amount *

Please Upload a Voided Check

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

If you do not have a voided check, please provide documentation from your bank with pre- printed routing and account numbers . With either the voided check or bank documentation , your direct deposit will go live on the first payroll after we receive this completed form (due by Tuesday at 10:00am for that Friday's payday.) If you do not have either of these, write your numbers here. Your direct deposit will take 2 weeks to go live while the bank tests the transmission.

Bank Account #2 *

Choose One - (Bank Account 2) *

Checking
Savings

Routing Number *

Account Number *

Enter % of Net Pay OR Dollar Amount *

Please Upload a Voided Check

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

If you do not have a voided check, please provide documentation from your bank with pre- printed routing and account numbers . With either the voided check or bank documentation , your direct deposit will go live on the first payroll after we receive this completed form (due by Tuesday at 10:00am for that Friday's payday.) If you do not have either of these, write your numbers here. Your direct deposit will take 2 weeks to go live while the bank tests the transmission.

Rapid PayCard

Access your paycheck funds on a rapid! Visa PayCard. Once activated, your pay will be deposited to a card account that will be created for you. A bank account is not required.

Enter % of Net Pay OR Dollar Amount *

I authorize Kaya HR to direct deposit my paycheck funds into the account(s) listed on this form.

Direct Deposit Registration

Rapid PayCard

Portland Office

Eugene Office