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City of Woodburn Direct Deposit Payroll We are pleased to be able to offer you a payday convenience – Direct Deposit Payroll and/or a U.S. Bank Focus Card. Now you can have your paycheck automatically deposited in your checking or savings account on payday; or loaded onto your Focus Card. The voluntary service of Direct Deposit is entirely free. We believe you will like the added convenience of having your salary automatically deposited for you. To take advantage of this service, complete and sign the authorization form and return it to the HR Analyst. Please know that from your first check, direct deposit or the Focus Card (if selected) will be utilized. What that means is that you need to be absolutely sure the information you are providing is current and accurate to avoid your check mistakenly being deposited into an account other than yours. We require you to provide us with a voided check or routing & account number printout from the bank/credit union so we can be sure to input your account information clearly without errors due to lack of clarity in handwriting. If you select to have your earnings loaded on a Focus Card you will receive your card with the first pay day, and earnings will be put on that card with each subsequent pay day. On pay day you will receive an earnings statement showing gross salary, taxes, other deductions, and net pay that have been deposited in your account or loaded on your Focus Card. All you need to do is complete the form below. If you are depositing all of your pay to one account, simply fill out the top section and write 100% on the “Percent to Deposit” line. Please attach voided check(s) to ensure accuracy. If you want all or some of your paycheck to be loaded on a Focus Card please selection option 3 and complete the information. Authorization for Automatic Payroll Deposit: (Employee’s Printed Name) I hereby authorize the City of Woodburn (the Company) to initiate credit entries and to initiate, if necessary, debit entries and adjustments for any credit entries in error to my account(s) indicated below and the depository named below (the DEPOSITORY) to credit and/or debit the entries to such account. Depository Checking or Savings Account Amount to Deposit Percent to Deposit or Balance of Net Pay Financial Institution Branch City State Zip Transit routing Number: Account Number: Depository Checking or Savings Account Amount to Deposit Percent to Deposit or Balance of Pay Financial Institution Branch City State Zip Transit routing Number: Account Number: Depository #3 - FOCUS CARD Amount to Deposit Percent to Deposit or Balance of Pay The Focus Card is issued by U.S. Bank National Association pursuant to a license from Visa U.S.A. Inc.©2025 U.S. Bank. Member FDIC. This authority is to remain in full force and effect until the City of Woodburn has received written notification from me of its termination or modification in such time and in such manner as to afford the City of Woodburn and DEPOSITORY and Focus Card a reasonable opportunity to act on it. Updated 9/25/2025 Signature Date