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  • Authorization Agreement

    I hereby authorize PRN STAFFING SOLUTIONS, INC to initiate automatic deposits to my account at the financial institution named below. I also authorize PRN STAFFING SOLUTIONS, INC to make withdrawals from this account in the event that a credit entry is made in error. Further, I agree not to hold PRN STAFFING SOLUTIONS, INC responsible for any delay or loss of funds due to incorrect or incomplete information supplied by me or by my financial institution or due to an error on the part of my financial institution in depositing funds to my account. This agreement will remain in effect until PRN STAFFING SOLUTIONS, INC receives a written notice of cancellation from me or my financial institution, or until I submit a new direct deposit form to the Payroll Department.

  • Name of Financial Institution: 
  • Date Format: MM slash DD slash YYYY
  • Please attach a voided check or deposit slip below.
  • Date Format: MM slash DD slash YYYY