Payroll Status Form

Your Name (First MI Last) (required)

Your Email (required)

What kind of change are you wanting to make

Street Address City/State/Zip

I hereby authorize AMX, Inc. to initiate electronic credit entries, and, if necessary, with prior notification to me, debit entries to reverse erroneous credits, to my:
CheckingSavings
Account, indicated below, and to the financial institution named below to credit and/or debit the same such account
Financial Institution Name

City, State (optional)

Routing/Transit number

Account Number

FlatPercentage
Amount you would like deposited in this account?

This authority is to remain in full force and effect until AMX Payroll Department has received written notification from me of its termination in such time as to afford the Company and Depository a reasonable opportunity to act on it
Employee Code

Please verify your employment status with the last 4 of your SSN, if this is incorrect the request will be ignored.
Required Field