Direct Deposit Authorization Form

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  • I authorize Community Action Network to initiate credit (deposit) entries and, if errors occur, I authorize the correction of entries to my account as indicated.

  • I understand that I may discontinue this authorization at any time by giving written notice to Accounting.

  • I acknowledge this information will be used solely for the purpose of direct deposit.

  • I authorize the full deposit of my net income* acquired by Community Action Network.
*Net income: Remaining dollar amount after all taxes, voluntary deductions, and other bank account amounts have been deducted.

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By signing this form, you agree to the aforementioned statements and attest to the accuracy of the provided information.
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