Direct Deposit

Direct Deposit Authorization

About This Form

This form must be completed and signed by the employee or subcontractor requesting automatic deposit of payments made to them.

First

Middle

Last

Address

Address Line 2

City

State / Province

ZIP / Postal Code

Country

Phone

Bank Name

Routing Number

Account Number

Type of Account

Personal Checking

Personal Savings

Business Checking

Business Savings

Date

This authorizes WGNR, LLC ("WGNR") to initiate credit entries (as well as any necessary debit, reversal, or adjustment entries) electronically or through any other commercially accepted method to my account and to any other accounts I may designate in the future using this form on the wgnr.co website (the "Account"). I also authorize the financial institution holding the Account to post all such entries. I acknowledge that the ACH transactions authorized herein will comply with all applicable United States laws.

This authorization will remain in effect until I provide written notice of cancellation, at which point WGNR will have a reasonable opportunity to process this change and delete my information from its systems.

By:

Signature

Sign Here