City of Orem

ACH Enrollment/Change Form

The City of Orem is moving all service vendor payments to direct deposit, rather than by check. Your payments will be deposited into the checking or savings account of your choice. In addition to having the money deposited electronically, you will also be notified of the deposit by email. The e-mail will provide you with all the information that would normally be on your check stub. To receive payments electronically, please fill out this form.
If you have any questions, please contact Makayla K Roberts at 801-229-7040 or mkroberts@orem.gov.

First Name

*Last Name/Business Name

*Mailing Address

*City

*State

*Zip

*SSN/Tax ID (if Business)

*Email

*Primary Phone

*Name on Account at Bank

*Routing Number

*Checking Account Number

I represent the organization and certify that the information above is correct