Customer Support
1 (855) 545-4380
support@lili.co
Direct Deposit Enrollment Form
Account Information
Account holder’s name
Julia Lujan
Bank Name
Choice Financial Group
Routing Number
091302966
Account Number
260104406558
Voided Check
Choice Financial Group
Julia Lujan
1234
12215 205th Ave. E
DATE
Bonney Lake WA, 98391
PAY TO THE
ORDER OF
VOID
MEMO
$
DOLLARS
a 091302966 a 260104406558 d 1234
The image of this voided check may be provided to your employer or other payer for no other purpose except to set up
direct deposit to your Lili Account.
Authorization
I authorize ______________(payer) to directly deposit my pay to the checking account listed above, and, if
necessary correct entries made in error. I understand that this authorization replaces any previous authorization and
will remain in effect until I modify or cancel it in writing.
Signature
Date
Banking Account Services provided by Choice Financial Group, Member FDIC. Direct deposit capability is subject to payer’s support of this
feature. Confirm with your payer to find out when the direct deposit of funds will start. Funds availability is subject to timing of your payer’s
funding. The recipient’s name on any deposits received must match the name of the Lili Account holder. Any deposits received in a name
other than the name registered to the Lili Account holder will be returned to the originator.