Payroll Allocation Form Direct Deposit printable pdf download

Payroll Allocation Form Direct Deposit

Payroll Allocation Form‐DIRECT DEPOSIT

Please check one:

New Setup

Change of Account

Cancellation

Employee Information:

Employee Name (printed): _________________________________________________

Employee @ Number: _____________________________________________________

Account Information:

Name of Financial Institution: ______________________________________________

Please choose one:

Checking

Savings

Routing Number:

Account Number:

To the left is a sample check for your reference when filling out

this direct deposit form.

PLEASE ATTACH A VOIDED CHECK

IMPORTANT Please read and sign before submitting to Payroll.

I hereby authorize the Fashion Institute of Technology (FIT) to deposit any amounts owed to me, as instructed by my

employer, by initiating credit entries to my account at the financial institution indicated on this form. Further, I authorize

the financial institution to accept and to credit any credit entries indicated by FIT to my account. In the event that FIT

deposits funds erroneously into my account, I authorize FIT to debit my account for an amount not to exceed the original

amount of the erroneous credit. This authorization is to remain in full force and effect until FIT has received notice from me

of its termination in such time and in such manner as to afford FIT reasonable opportunity to act on it.

It will take two pay periods for direct deposit to go into effect.

Employee Signature: ________________________________________________ Date: _________________

Prepared by: Martha Acosta

Revised: March 16, 2009

Payroll Allocation Form Direct Deposit