Convenient Banking Just Got Easier.
Santander Bank makes it easier to sign up for direct deposit. Once you’ve opened an account it’s simple.
Complete the fields provided below, print out the form, and give it to your employer and other institutions
making deposits on your behalf.
Please complete the fields provided below.
Customer Name
Address
City / State / ZIP
Effective immediately, please credit my direct deposit to the Santander Bank account identified below.
Effective on , please credit my direct deposit to the Santander Bank account identified below.
Santander Bank Account Type: Checking Savings Account Number
:
Santander Bank Routing #’s
Amount to Deposit:
Net Amount
Other: $ to Account Number and the
remainder to Account Number .
I authorize to initiate credit entries and, if necessary, to initiate any debit
entries to correct erroneous credit entries to my accounts at Santander Bank, N.A. I understand that this authorization replaces any
previous authorization and will remain in full force and effect until the company named above has received written notification
from me of its termination in such time as to afford the company and depository a reasonable opportunity to act. While the
bank has provided this form to me for my convenience, I understand that some companies and/or governmental agencies
(such as the Social Security Administration) may require their own forms.
Signature Date
Santander Bank, N.A. is a Member FDIC and a wholly owned subsidiary of Banco Santander, S.A. ©2013 Santander Bank, N.A. Santander and its logo are registered
trademarks of Banco Santander, S.A. or its affiliates or subsidiaries in the United States and other countries. N3584 10/13
On or before May 17, 2012,
Accounts Opened
in CT, MA, NH, or RI: 011075150
After May 17, 2012, Accounts Opened in
CT, MA, NH, or RI:
231372691
Accounts Opened in MD, NJ, NY, PA, or DE: 231372691
