Multiple Direct Deposit Account Setup Form printable pdf download

Multiple Direct Deposit Account Setup Form

Printed Name

Associated Students, California State University, Northridge, Inc.

Company Name:

The following information is REQUIRED in order to complete your request:

Indicate+whether+your+pay+will+be+deposited+in+your+checking+or+savings+account

Attach+a+voided+check+or+printout+from+your+bank

Sign+the+form

Set$up'typically'takes'one'or'two'payroll'cycles'to'process.''Do'not'consider'your'direct'deposit'account'set'up'until'you'

have'personally'confirmed'it'with'your'bank.''

Direct Deposit Sequence No. 1

! New

! Change

! Cancel

Routing number:

Bank Name:_______________________________________

___ ___ ___ ___ ___ ___ ___ ___ ___

Account Type: ! Checking

! Savings

Account Number: ______________________________________

Deposit Rule: ! Available Balance ! Percent Amount _________%

! Dollar Amount $ ___________

Direct Deposit Sequence No. 2

! New

! Change

! Cancel

Routing number:

Bank Name:_______________________________________

___ ___ ___ ___ ___ ___ ___ ___ ___

Account Type: ! Checking

! Savings

Account Number: ______________________________________

Deposit Rule: ! Available Balance ! Percent Amount _________%

! Dollar Amount $ ___________

Direct Deposit Sequence No. 3

! New

! Change

! Cancel

Routing number:

Bank Name:_______________________________________

___ ___ ___ ___ ___ ___ ___ ___ ___

Account Type: ! Checking

! Savings

Account Number: ______________________________________

Deposit Rule: ! Available Balance ! Percent Amount _________%

! Dollar Amount $ ___________

Employee Signature _____________________________________________________________ Date _______________________

Multiple Direct Deposit Account Setup Form

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