Direct Payroll Deposit Or Dbhdd Debit Master Card Form

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Georgia Department of Behavioral Health & Developmental Disabilities
DIRECT PAYROLL DEPOSIT OR DBHDD DEBIT MASTER CARD FORM
 What is direct payroll deposit or DBHDD Debit Master Card (DMC)?
Direct payroll deposit or the DBHDD Debit Master Card is a way to electronically deposit your net paycheck
into either your personal bank account, or electronically transfer your net pay onto a debit card on payday.
 Why should I use direct payroll deposit or DBHDD Debit Master Card?
Imagine not having to worry about getting to the bank before it closes, no more waiting in line to deposit
your paycheck, or wondering how to get and deposit your paycheck if you are not scheduled to
work on payday. These are some of the benefits of direct payroll deposit.
 When is my net pay deposited into my account or onto my DBHDD Debit Master Card?
Your net pay should be deposited by 2:00 p.m. on payday.
 How do I qualify and sign up for direct payroll deposit?
All DBHDD employees qualify for direct payroll deposit. To sign up, complete the form at the bottom of this page and attach a
voided check or savings withdrawal slip. Then, give it to your personnel office. The personnel office and payroll will take care of the
rest.
 How do I qualify and sign up for the DBHDD Debit Master Card?
All DBHDD employees qualify for the DBHDD Debit Master Card. To sign up, complete the form at the bottom of this page and
return to your personnel office.
Authorization Agreement for Automatic Deposit of Net Pay
I authorize the Department of Behavioral Health and Developmental Disabilities (DBHDD) to deposit my net pay directly into my
Bank/Debit Master Card account. DBHDD is also authorized to adjust any over/under deposit that it has caused to be made to my
account.
I recognize that the deposit of my net pay shall be made by electronic means. I further acknowledge that the responsibility of
DBHDD to provide me my net pay shall be satisfied by DBHDD providing a correct credit entry in accordance with the automatic
deposit services agreement (credits) between DBHDD, and SunTrust Bank, or Comerica.
The net amount of my paycheck is to be deposited into my:
Checking Account
Saving Account
DBHDD Debit Master Card Account - (An account number will be assigned and a DMC will be mailed to you)
At ____________________________________ (name of your financial institution). Attached is a voided check
savings withdrawal
or
slip showing the correct information for my account. If I change my bank or my bank account, I am responsible for notifying the
DBHDD Office of Financial Services Payroll Subsection in writing of the change immediately.
In signing this authorization for direct payroll deposit or Debit Master Card, I understand that certain checks will not be automatically
deposited into my account bank account or on to my Debit Master Card but will be given to me. These checks are:
1.
First check after Payroll Subsection sets up Direct Deposit in my record. (Bank requires prior notification.)
2.
First check after Payroll Subsection enters authorized changes in my bank account.
3.
Last check paid to me upon my termination/resignation from the department.
4.
Any check that is not run at least three (3) days prior to payday.
Signature: _______________________________________ Social Security Number:
___________________
Current Mailing Address:______________________________________________________________________
Office Telephone Number_________________________________
Date: _____________________________
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