Senath State Bank Direct Deposit Form
Please complete the direct deposit form and forward it to your payroll department for faster processing.
Authorization Code: New Change Cancel
 I authorize you and Senath State Bank to initiate electronic credit entries,
 and if necessary, debit entries and adjustments for any credit entries in error to my:

  Checking Account #  $ 
  Savings Account #  $ 
 each pay period. This authority will remain in effect until I have cancelled it in writing.
Financial Institution Information Account Holder Information
 Financial Institution: Senath State Bank  Name (Please print):
 Address: 117 Commercial Street  SS#:
 City, State, Zip: Senath, MO 63876  Signature:
 Employer Name:  Date:
 Address:
 City, State, Zip:
081518016
TRANSIT ROUTING NUMBER (ABA)
STAPLE VOIDED CHECK HERE.