Portland Payroll, Inc. Employee Changes Only Form

Employee Changes Only Form

Do you use our Timekeeping System? *
Do you want to add another change to the employees record?

Employment Information

Pay Type *
Filing Status *

Platinum Pay Card Enrollment

*Note:  To enroll for a Platinum Visa Pay Card you need to go to the Portland Payroll Inc. web site and in the forms section, download the application "Platinum Visa Pay Card Enrollment Application" which is supplied in a PDF format. The form needs to be signed by the applicant and faxed to the number at the bottom of the application page.

Bank/Direct Deposit Information/Pay Card Information

Maximum number of Direct Deposit accounts is three (3). For Direct Deposit into checking account, please provide a copy of a voided check. For Direct Deposit into a savings account, please provide a deposit slip. For more than one account, fill in the fixed amounts or percentages. Direct Deposits may take up to one payroll cycle to become effective.

 $ or %Routing NumberAccount NumberBank Name
Checking 1
Checking 2
Checking 3
Note:  If the employee is transferring part of their pay check into a savings account, please contact the employees bank to verify the savings account routing number.
 $ or %Routing NumberAccount NumberBank Name
Savings 1
Savings 2
Savings 3
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