Direct Deposit Authorization Form
Download a blank fillable Direct Deposit Authorization Form in PDF format just by clicking the "DOWNLOAD PDF" button.
Open the file in any PDF-viewing software. Adobe Reader or any alternative for Windows or MacOS are required to access and complete fillable content.
Complete Direct Deposit Authorization Form with your personal data - all interactive fields are highlighted in places where you should type, access drop-down lists or select multiple-choice options.
Some fillable PDF-files have the option of saving the completed form that contains your own data for later use or sending it out straight away.
ADVERTISEMENT
1BALL STATE UNIVERSITY PAYROLL & EMPLOYEE BENEFITS
Authorization for Direct Deposit
Instructions:
1. Fill in the form.
2. Direct deposit can be made up to 4 financial institutions. To designate deposits to more than two financial
institutions, please submit a second Authorization form and re-number the form to match your allocation up to a
maximum of four banking designations.
3. Print the completed form, sign and mail on campus to:
BALL STATE UNIVERSITY~ PAYROLL DEPARTMENT~AD Rm. 029~2000 W. University Ave Muncie, IN 47306
BSU ID: __________________________
Last Name:_______________________ First Name:____________________ M.I. _________
START
STOP
CHANGE
direct deposit
direct deposit
my current
to the financial
send to payroll BEFORE
direct deposit by stopping any and
institution(s) noted below
closing your account
all authorizations now in force by me and replacing
with the financial information listed below.
NOTE: You may designate direct deposit by either percent or amount, but not both. This direct deposit information will be used to
distribute ALL PAYROLL payments from Ball State University.
1)
Financial Institution: __________________________________________________________
Bank Routing Number: _________________________________________________________
Bank Account Number: ______________________________________________________
Complete only 1 of the following:
Checking
Savings
_________percent (%) OR
$ _________Amount
Only complete if you elect to designate the remaining portion of your direct deposit to additional financial institution
or account.
2)
Financial Institution: __________________________________________________________
Bank Routing Number: ______________________________________________________
Bank Account Number: ______________________________________________________
Complete only 1 of the following:
Checking
Savings
_________percent (%) OR
$ _________Amount
I hereby authorize Ball State University to deposit my payroll amounts automatically to my account at the financial institution(s) indicated above. I
understand that the very earliest I can expect my checking or saving account(s) to be credited will be on payday. I further understand that if I
change or terminate my account(s) without notifying Ball State payroll in writing my pay may be delayed.
Signature: ________________________________
Date: _________________________
FOR ACCOUNTING PAYMENTS (ie EMPLOYEE TRAVEL, EXPENSE REIMBURSEMENTS, FINANCIAL AID, ETC) FOLLOW THE LINK BELOW TO A SECURE SITE TO ENTER
YOUR BANK INFORMATION FOR THE ACCOUNTING DEPARTMENT.
https://
ADVERTISEMENT
0 votes
Related Articles
Related forms
Related Categories
Parent category: Business