Direct Deposit Authorization

Creating Lasting Memories Through Beautiful Photography.

Employee authorization for electronic ACH direct deposit of wages under EFTA / Reg E. Captures routing/account, split allocations, void-check attachment, and revocation rights. Complies with NJ/PA/NY/CT wage-payment laws.

BTL-PBL-05.014

Form

Vol 05 — Human Resources & Talent

Employee

Full name *

Employee ID / SSN (last 4) *

Department / position

Effective pay date *

Action *— New enrollment · Change · Cancel.

Primary Account (100% unless splits below)

Bank / credit union name *

Routing number (9 digits) *

Account number *

Account type *— Checking · Savings.

Amount / percentage of net pay *— e.g., 100%, or fixed $ with remainder to secondary.

Voided check or bank letter attached (required for verification) *

Yes / N/A

Secondary Account (optional)

Bank name

Routing number

Account number

Account type

Amount / percentage

Authorization & Notices (EFTA / Reg E and state wage-payment laws)

I authorize Beauty Through the Lens L.L.C. and its payroll provider to deposit my net pay electronically to the account(s) listed above and, if necessary, to reverse any credit made in error. *

Yes / N/A

I acknowledge that I selected the financial institution(s) above and was not required to use any specific institution (15 U.S.C. § 1693k). *

Yes / N/A

I understand this authorization remains in effect until I provide written revocation with reasonable time to act. *

Yes / N/A

Employee signature *

Date *

Payroll Use Only

Verified by (name & title)

Pre-note test date

Live date

Prepared by

Name · Title · Date

Reviewed by

Name · Title · Date

Approved by

Owner · Katheryn L. Wilkins · Date

Controlled document — BTL-PBL-05.014. Complete all required fields (marked *). Retain per Volume 15 retention schedule.