Employee Direct Deposit Enrollment Form

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Employee Direct Deposit Enrollment Form
_____________________________________________
________-_____-____________
Employee Name
Social Security Number
Important! Read and sign before completing and submitting.
I hereby authorize Trinity College to deposit my net payroll or the amounts indicated below
with the institution(s) specified below for credit to my account. I understand that this
authorization will remain in effect throughout my employment unless cancelled by me in writing
or Trinity College.
In the event that Trinity College deposits funds erroneously into my account, I authorize Trinity
College to debit my account for an amount not to exceed the original amount of the error.
The electronic funds transfer system requires a pre-notification of all new account numbers. I
understand the pre-notification process may take up to three pay periods to complete. A live
check will be issued until the accounts are verified and activated.
Employee Signature: __________________________
Date: ___________________
____________________________________________________________________________
Account Information:
1. Bank Name/City/State: _____________________________________________________________
Routing/Transit #: __ __ __ __ __ __ __ __ __
Account #: ________________________________
Checking
Savings
I wish to deposit $__________. ____ Or
Entire Net Amount
2. Bank Name/City/State: _____________________________________________________________
Routing/Transit #: __ __ __ __ __ __ __ __ __
Account #: ________________________________
Checking
Savings
I wish to deposit $__________. ____ Or
Entire Net Amount
3. Bank Name/City/State: _____________________________________________________________
Routing/Transit #: __ __ __ __ __ __ __ __ __
Account #: ________________________________
Checking
Savings
I wish to deposit $__________. ____ Or
Entire Net Amount
____________________________________________________________________________
Attach a voided check for each checking account-not a deposit slip. If depositing into a savings
account, ask your bank to give you the Routing/Transit number for your account. Routing/Transit
Numbers are not always the same on deposit slips. This will insure that your deposit will
properly authorize for the pre-noting process.
FOR PAYROLL OFFICE USE ONLY
Date Keyed in Payroll: ____________________
Date Sent to Pre-Note: _________________
Date Effective: ____________
Signature of Payroll Manager: ________________________________

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