Automatic Deposit Transmittal Form - Langston University (Page 2 of 2) in pdf

Automatic Deposit Transmittal Form - Langston University Page 2

AUTOMATIC DEPOSIT AUTHORIZATION INSTRUCTIONS

Do not fill out or submit this form for change of Address or Name change.

1. Social Security Number

Enter employee social security number.

2. Name

Type or print employee name exactly as it appears on your account.

3. Type of Account

Indicate whether your account is a checking or savings account.

4. Financial Institution Name

Enter the name of the bank, savings and loan or credit union where your account is

held, i.e.: Bank-One.

5. Financial Institution, City, State

Enter the city and state of your financial institution.

6. Employing Agency

Enter the name of the state agency you work for.

NOTE-A request form cannot be processed

7. Signature and Date

Sign and date the request form.

without your signature as authorization.

8. Voided Check

For deposit to a checking account, attach to this request a VOIDED check from the

financial institution of your choice so that we can use the information to make a

proper deposit. For a deposit to a savings account, provide a document from your

account number.

NOTE-A request form cannot be processed without this

information. Thank you.

9. Paycard

If Key2Prepaid paycard is selected, place the following information in the

Financial Institution box: KeyBank ABA 041201703

WHAT HAPPENS NEXT

The pay stub will not change, you will continue to receive a record of your earnings through Web for Employees via

If you should have any problems, follow the procedures listed below:

1. Call your bank and ask for Commercial Direct Deposit Assistance. Advise them that you are on direct deposit through

speak to an Officer of the Bank, a Teller

Supervisor or a Customer Service Representative. Write down the names of the people you talk to and the phone

number you called.

2. For Payroll Deposits

If you are not satisfied with the results for pay warrants, contact the Langston University payroll office at (405) 466-

2985. You must have completed Step 1 before calling the payroll office. We will need the phone number(s) and

name(s) of the individual(s) you spoke with at your bank.

3. For Key2Prepaid Paycard Deposits

Contact KeyBank Customer Service 1-866-295-2955 or Then follow the procedures in Step 1.

Automatic Deposit Transmittal Form - Langston University Page 2