Direct Deposit Cancellation Request - Student Accounts Office printable pdf download

Direct Deposit Cancellation Request - Student Accounts Office

Student Accounts Office

4400 University Drive, MS 2E2, Fairfax, Virginia 22030

Phone: 703-993-2484 Fax: 703-993-2490

Direct Deposit Cancellation Request

(Please Print)

Student ID:

Date:

Student Name: _____________________________________________________________

Last

First

M.I.

COMPLETE THIS SECTION TO DISCONTINUE DIRECT DEPOSIT OR IF YOU CLOSE YOUR ACCOUNT

I wish to discontinue direct deposit to the following financial institution:

Financial Institution: _________________________________

Account Number:

NON-PAYROLL DIRECT DEPOSIT RULES AND DEADLINES

PLEASE NOTE: You must attach a voided check to this direct deposit authorization.

• I understand that the termination of direct deposit will take effect following receipt of this form by the Student

Accounts Office.

• I understand that it may take up to six working days to process this request. Emergency cancellation requests

must be brought to the attention of Student Accounts Office staff.

• Direct deposit refunds in process can not be recalled, and if sent to a closed bank account will be returned to

George Mason University. Once received, the refund will be reissued based on the original payment type. Please

refer to the Refund Policy on the Student Accounts website for additional information:

______________________________________

Signature

Date

•

If you direct deposit your GMU payroll check, this routing information will not change your payroll direct deposit.

Changes to your bank account must be made in both places.

Direct Deposit Cancellation Request - Student Accounts Office