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Forms Library
Forms for Centralized Direct Deposit & Official Checks/Positive Pay

Enrollment Forms
To begin your enrollment, complete and fax these forms to us at 703-556-7575. We’ll take it from there and send a confirmation that your request has been processed.
Payroll/HR and Electronic Funds Transfer Services Agreement
This details Pay America’s risk management controls with respect to the electronic money movement services provided to you.
Funding Authorization ACH Forms
You are giving information and authorization for direct deposit funds, official checks funds and/or tax filing funds to be taken from your payroll account and dispersed for payments.

Forms for Direct Deposit, Official Checks and Positive Pay
Once you’ve enrolled, keep these forms (or this link) on hand for when you need to start or stop payments or order copies of checks.

Employee Authorization Form –Direct Deposit Stop Payment or Reversal Request
This form gives you the authority to take the money back out of an employee’s account if you make a payroll error and over-pay them. Your employees should complete this form, and attach a "void" check for account and routing number verification. Be careful not to accept deposit tickets; they often have the wrong routing/transit number.
Stop Payment/Reversal Form – Direct Deposit and Official Checks:
If you make an error on your payroll, you can fax us the attached form with information from your payroll registers. We will handle it from there, initiating the appropriate transactions, and letting you know the status of them upon settlement.

If you would like to talk to a Pay America customer service representative now, please call 703-556-7550.
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