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Direct Deposit Change

Store Number
Checking or Savings Account

By submitting this form you hereby authorize the payroll system, on behalf of my employer PG1 restaurants and its affiliates to initiate credit entries and to initiate, if necessary, debit entries and adjustments for any credit entries in error to my account or accounts listed below. I acknowledge that the origination of ACH transactions to my account must comply with the provisions of the U.S. Law. I also agree to receive online paystubs: This authorization will remain in full force and effect until my EMPLOYER has received written notice from me of its termination and has had a reasonable opportunity to act on that notice.

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