Employee Direct Deposit Enrollment Form - Buckley Day Camp printable pdf download

Buckley Country Day School

Employee Direct Deposit Enrollment Form

To enroll in Full Service Direct Deposit, simply fill out this form and give it to your payroll manager.

IF USING A CHECKING ACCOUNT, PLEASE ATTACH A VOIDED CHECK. Do not provide a deposit slip as the numbers may not be the

same. IF USING A SAVINGS ACCOUNT, HAVE YOUR BANK PROVIDE YOUR ACCOUNT NUMBER AND ROUTING NUMBER ON BANK

LETTERHEAD. This will help to ensure that you are paid correctly.

Below is a sample check detailing where the information necessary to complete this form can be found.

IMPORTANT! Please read and sign before submitting.

I hereby authorize ADP to deposit any amounts owed me, as instructed by my employer, by initiating credit entries to my account at the financial

institution (hereinafter "Bank") indicated on this form. Further, I authorize Bank to accept and to credit entries indicated by ADP to my account. In

the event that ADP deposits funds erroneously into my account, I authorize ADP 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 ADP and Bank have received written notice from me of its termination in such time and

in such manner as to afford ADP and Bank reasonable opportunity to act on it.

Employee Name:__________________

Social Security #:_______________________

Employee Signature:_______________

Date:_________________________________

__________________________________________________________________________________________________

Account Information (Please make sure to indicate what type of account)

Bank Name/City/State:_________________________________________________________________

Routing/Transit #:__________________

Account Number:________________

Checking

Savings

Other

Payroll Manager- Please complete this section and send a copy to ADP for enrollment. (Please Print)

Company Code: NYH

Company Name: Buckley Country Day School

Date:________

Payroll Mgr. Name:_______________________

Payroll Mgr. Signature:_____________

Employee Direct Deposit Enrollment Form - Buckley Day Camp