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- Click ‘Get Form’ to open it in the editor.
- Select whether this is a new authorization, an update, or a cancellation by checking the appropriate box at the top of the form.
- Indicate your deposit preference by selecting either ACH/Direct Deposit or Payroll Deduction. If you choose Payroll Deduction, note that it may take longer to receive your funds.
- Fill in the amount you wish to deposit under 'Partial Pay' if applicable, or check 'Full Pay' for complete deposits.
- Choose between Checking or Savings for your deposit account.
- Complete your member information including MICR number and name. If applicable, provide employer details for L.A. County/Panda Employees.
- Sign and date the authorization at the bottom of the form to validate your request.
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| Versions | Form popularity | Fillable & printable |
|---|---|---|
| 2017 | 4.4 Satisfied (29 Votes) |
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