Deposit Form

In-Home Massage
by The Massage Place

Authorize Agreement for Direct Deposit

* Indicates required field

Name *

First

Last

I hereby authorize The Massage Place to initiate credit for commission to my:

Choose One *

Checking Saving

I further authorize debit entries or adjustment in the event of an error in connection with my commission.

Bank Name *

Routing Number *

Account Number *

Venmo Account: *

Upload Your Venmo QR Code *

Max file size: 20MB

By click submit, this authorize is to remain in full force and effect until canceled by me. In the even of said cancellation, I agree to do so in writing and deliver same to The Massage Place and the 3rd party payroll company.

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