Driver Info Vehicle Info Documents Upload Payment Info Agreement Info Files Uploaded Successful Files Uploaded Successful. Who is receiving your payments? YOU:Payments go directly to you as an individual ANOTHER ENTITY:Payments go to another entity such as a business Please enter the name of the business or entity that will receive your payments Payment Information I Authorize Via to automatically deposit my payroll check with my account listed above. This authorization will remain in effect until I give written notice to cancel it. I certify under penalty of perjury: 1. The number shown on this form is my correct taxpayer identification number 2. I am not subject to backup withholding because: (a) I am exempt from backup withholding, or (b) I have not been notified by the Internal Revenue Service (IRS) that I am subject to backup withholding as a result of a failure to report all interest or dividends, or (c) the IRS has notified me that I am no longer subject to backup withholding. Send Please fill previous Step
