Employee Direct Deposit Enrollment Form printable pdf download

Employee Direct Deposit Enrollment Form

Payroll – Please complete this section and send a copy to ADP for enrollment. (Please print.)

Company Code:

Company Name:

Goucher College

Employee File Number:

To enroll in Full Service Direct Deposit, simply fill out this form and give to your payroll manager. Attach a voided check for each checking account - not a deposit

slip. If depositing to a savings account, ask your bank to give you the Routing/Transit Number for your account. It isn’t always the same as the number on a savings

deposit slip. This will help ensure that you are paid correctly.

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

Account Information

The last item must be for the remaining amount owed to you. To distribute to additional accounts, please complete another form.

Make sure to indicate what kind of account, along with amount to be deposited, if less than your total net paycheck.

Bank Name:

Routing Transit #:

Account Number:

Checking

Savings

Other

or Entire Net Amount

I wish to deposit: $

Bank Name:

Routing Transit #:

Account Number:

Checking

 Savings

Other

or Entire Net Amount

I wish to deposit: $

Bank Name:

Routing Transit #:

Account Number:

 Checking

 Savings

 Other

or Entire Net Amount

I wish to deposit: $

IMPORTANT! Please read and sign before completing and submitting.

I hereby authorize ADP to deposit any amounts owed me, as instructed by my employer, Goucher College, 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 any credit entries indicated by ADP to my account. In the even

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.

Please note: You will receive a live paper check for one to three pay cycles while your new direct deposit election completes the pre-note testing phase. Your check

will be mailed to your on campus department/mailbox during this time. Once the pre-notes testing has successfully completed you will be paid via direct deposit, as

elected above, and receive your paystub online at

Employee Name:

Phone #:

Employee Signature:

Date:

Employee Direct Deposit Enrollment Form

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