If your bank is in Philadelphia, print "Phila. , PA." If your bank is not in Philadelphia, print your bank's address. 5.DIRECTIONS. To sign up for Direct Deposit, the payee is to read the back of this form and fill in the information requested in Sections 1 and 2. The name and address of your financial institution; Your account number; Your routing number; Financial institution phone number. Complete this form and provide it to your employer's payroll department. Name (please print). Signature. Date. Fill out this section start or change your direct deposit. If you are canceling your direct deposit, leave this section blank. Below you will find links to useful forms and documents for easy and convenient access. Electronic payments are required!