Account Credit

DIRECT DEPOSIT

support.current.com ENROLLMENT FORM

ACCOUNT INFORMATION

NAME

Nicole Spatola

LAST 4 OF SSN ID NUMBER

ADDRESS

**** *** **, **********, ** 95838

DEPOSITORY ACCOUNT INFORMATION

DEPOSITORY NAME

Current

ROUTING NUMBER

091302966

ACCOUNT NUMBER

304*********

AMOUNT TO DEPOSIT

100%

VOIDED CHECK

PAY TO THE

ORDER OF

Choice Financial Group • 4501 23rd Ave South Fargo ND 58104 123

$

DOLLARS

DATE

MEMO

VOID

091302966 304*********-***

Nicole Spatola

4530 May St

Sacramento, CA 95838

The image of this voided check may be provided to your employer or other payer for no other purpose except to set up direct deposit to your Current Account. AUTHORIZATION SIGNATURE

I authorize Dasher (employer/payer) to initiate credit entries, and, if necessary to initiate any debit entries to correct previous credit errors, to my Current Individual Account. This authority will remain in effect until I notify my employer or other payor in writing or as otherwise specified by my employer or payer. SIGNATURE

DATE

Nicole Spatola 02/20/2022

Contact this candidate