Payroll Direct Deposit Form

INSTRUCTIONS:

Complete the form,.

Click the SUBMIT button.

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

Employee Name: *

Employee email: *

Effective Date: * +

Employee ID

Please check the appropriate box: *

Initial Authorization

Change

Discontinue

Account Type: *

Checking

Savings

Bank Name *

Routing/Transit Number *

Account Number *

Amount *

Add another account? *

Yes

No

Account Type:

Checking

Savings

Bank Name

Routing/Transit Number

Account Number

Amount

I hereby authorize Spoon River College to deposit any amounts owed by initiating credit entries to my account at the finical institution (hereinafter "Bank") indicated on this form. Further, I authorize Bank to accept and to credit any credit entries indicated by Spoon River College to my account. In the event deposits funds erroneously into my account; I authorize Spoon River College to debit my account for an amount not to exceed the original amount of erroneous credit. This authorization is to remain in full force and effect until Spoon River College and Bank have received written notice from me of its termination in such time and in such manner as to afford Spoon River College and Bank reasonable opportunity to act on it. *

I acknowledge that clicking the box and submitting is considered an electronic signature for the purpose of authorizing direct deposit of any amounts owed to me.