AUTHORIZATION AGREEMENT FOR AUTOMATIC DEPOSITS. (ACH CREDITS) (Please read page 1 before completing this form)
AUTHORIZATION AGREEMENT FOR AUTOMATIC DEPOSITS. I (we) hereby authorize ATSU to initiate credit entries and to initiate, if necessary, debit entries and adjustments for any credit entries in error to my (our) bank account indicated below and the bank named below to credit/debit the same to such account. I (we) understand that there will be no test deposit sent to my (our) account prior to the first student account refund. FINANCIAL INSTITUTION INFORMATION: NAME OF BANK ABA (ROUTING) NUMBER OF YOUR FINANCIAL INSTITUTION (9 digits on bottom left of check, not from deposit slip.) ACCOUNT NUMBER TO BE USED TYPE OF ACCOUNT: CHECKING SAVINGS BANK’S PHONE# This authority is to remain in full force and effect until the ATSU Finance Office has received written notification from me (or either of us) of its termination in such time and in such manner as to afford ATSU and the financial institution a reasonable opportunity to act on it. I (We) will be held accountable for any bank fee charges resulting from inaccurate transfer information provided. My (Our) signature(s) below indicate agreement with the above terms and conditions for automatic deposits. NAME(S) ON ACCOUNT SIGNATURE 1 SOC. SEC. # SIGNATURE 2 SOC. SEC. # DATE SIGNED XXXX takes responsibility to protect the privacy and confidentiality of our students’ information seriously. We maintain safeguards to store and secure information about you from unauthorized access, alteration, and destruction. All emails sent to and from an ATSU email address are encrypted.
AUTHORIZATION AGREEMENT FOR AUTOMATIC DEPOSITS. (ACH) I (we) hereby authorize DeSoto Independent School District, hereinafter called COMPANY, to initiate credit entries and to initiate, if necessary, debit entries and adjustments for any credit entries in error to my (our) account(s) indicated below and the depository named below, hereinafter called DEPOSITORY, to credit, and/or debit the same to such account. PRIMARY DEPOSITORY BANK CHECKING SAVINGS BANK NAME Office Use Only ROUTING NUMBER (PLEASE CALL YOUR BANK TO CONFIRM ROUTING NUMBER) ACCOUNT NUMBER SECONDARY DEPOSITORY BANK CHECKING SAVINGS BANK NAME AMOUNT $ ROUTING NUMBER (PLEASE CALL YOUR BANK TO CONFIRM ROUTING NUMBER) ACCOUNT NUMBER NAME EMP. NUMBER PLEASE PRINT CAMPUS DATE SIGNATURE **ATTACH VOIDED CHECK TO THIS AUTHORIZATION** This authority is to remain in full force and effect until COMPANY has received written notification from me (or either of us) of its termination in such time and in such manner as to afford COMPANY and DEPOSITORY a reasonable opportunity to act on it. Preferably 15 working days prior to specified pay date.
AUTHORIZATION AGREEMENT FOR AUTOMATIC DEPOSITS. DISTRICT: Amherst School District Souhegan School District Mont Xxxxxx School District SAU Employee Name: I authorize my employer to initiate the electronic entries necessary to directly deposit all or a portion of my net pay each pay period according to the following allocations: (this form hereby revoke all prior authorizations made by me). Account 1st Financial Institution Name 9 Digit Routing Number # Account # (Circle one) checking or savings Full Deposit or Fixed Amt $ 2nd Financial Institution Name 9 Digit Routing Number # Account # (Circle one) checking or savings Remaining Deposit or Fixed Amt $ 3rd Financial Institution Name 9 Digit Routing Number # Account # (Circle one) checking or savings Remaining Deposit or Fixed Amt $ 4th Financial Institution Name 9 Digit Routing Number # Account # (Circle one) checking or savings Remaining Deposit or Fixed Amt $ Please verify routing and account numbers for both savings and checking accounts listed and attach a deposit slip for saving account and/or a voided check. Please allow up to 2 pay cycles for this authorization to take effect. I hereby authorize the above school district to initiate credit entries and to initiate, if necessary, debit entries and adjustments for any credit entries in error to my account(s). This authorization is to remain in full force and effect until the district receives written notification from me or my termination of employment.
AUTHORIZATION AGREEMENT FOR AUTOMATIC DEPOSITS. I hereby authorize Moon‐Xxxxx‐Xxxxxxx Operating Co., Inc.(MHT) to initiate credit entries to our account via EFT (Electronic Funds Transfer). This will remain in effect until Owner provides written notification to MHT of termination. Please deposit payments to my account information listed below: Please print clearly to avoid mistakes OWNER NAME: SOCIAL SECURITY OR TAX IDENTIFICATION NUMBER: OWNER CODE(Top left corner of current Revenue Check): PHONE NUMBER: EMAIL ADDRESS (REQUIRED for check stub detail ): BANK INFORMATION: TYPE OF ACCOUNT (Check one): Checking Savings BANK NAME: BANK ADDRESS: ACCOUNT NAME: BANK ROUTING NUMBER (ABA): BANK ACCOUNT NUMBER: OWNER SIGNATURE: Return this form by mail to address above or by fax to: 601‐572‐8311. Any questions concerning this form, please contact Xxxxxxx Xxxxx by phone at (601) 573‐8300 or by email: xxxxxx@xxxxxxxxx.xxx.
AUTHORIZATION AGREEMENT FOR AUTOMATIC DEPOSITS. I hereby authorize THE CENTRAL PENNSYLVANIA TEAMSTERS PENSION FUND to directly depos- it my monthly pension benefit into Bank Name: Checking account number Bank ABA (ROUTING) No.: (contact your bank to obtain this 9 digit number) OR Savings account number Bank ABA (ROUTING) No.: (contact your bank to obtain this 9 digit number) Your Name: SS#: Your Phone No.: Date: Your Signature: It takes 30 days for the direct deposit to go into effect. Therefore, your FIRST MONTHLY CHECK will be sent to your home address. If you are already receiving your benefits and are making a change to the account information already on file, your next check MAY be mailed to your home address.
AUTHORIZATION AGREEMENT FOR AUTOMATIC DEPOSITS. I hereby authorize THE CENTRAL PENNSYLVANIA TEAMSTERS PENSION FUND to directly deposit my monthly pension benefit into Bank Name: Checking account number Bank ABA (ROUTING) No.: (contact your bank to obtain this 9 digit number) OR Savings account number Bank ABA (ROUTING) No.: (contact your bank to obtain this 9 digit number) Participant’s Name: Participant’s SS#: Participant’s Phone No.: Today’s Date: Participant’s Signature**: It takes 30 days for the direct deposit to go into effect. Therefore, your FIRST MONTHLY CHECK will be sent to your home address. If you are already receiving your benefits and are making a change to the account information already on file, your next check MAY be mailed to your home address. **If there is a Power of Attorney on file with the Fund, the form must be signed by the Power of Attorney. The Power of Attorney must sign the Participant’s name first followed by their name as Power of Attorney. For example – Xxxx X. Xxxxx, Xxxx X. Xxxxx, Power of Attorney.
AUTHORIZATION AGREEMENT FOR AUTOMATIC DEPOSITS. The Organization authorizes Ministry Trust, LLC. to electronically deposit any distribution to the bank account specified on the voided check stapled below. If monies to which the applicant or Organization is not entitled are deposited to the applicant’s account, the applicant authorizes Ministry Trust, LLC. to direct the financial institution to return said funds. This authority will remain in effect until the applicant has filed a new authorization or until revoked in writing. Organization Name: Address: City: State: GA Zip: Phone: Signature: Date: Name: Title: Phone: Email: v5.1.34.9_10222 31 Statement of Common Belief Scripture The Holy Bible was written by men divinely inspired and is God’s revelation of Himself to man. It is a perfect treasure of divine instruction. It has God for its author, salvation for its end, and truth, without any mixture of error, for its matter. Therefore, all Scripture is totally true and trustworthy. God There is one and only one living and true God. He is an intelligent, spiritual, and personal Being, the Creator, Redeemer, Preserver, and Ruler of the universe. God is infinite in holiness and all other perfections. God is all powerful and all knowing; and His perfect knowledge extends to all things, past, present, and future, including the future decisions of His free creatures. To Him we owe the highest love, reverence, and obedience. The eternal triune God reveals Himself to us as Father, Son, and Holy Spirit, with distinct personal attributes, but without division of nature, essence, or being. Xxxxxx Xxxxxx is the eternal Son of God. In His incarnation as Xxxxx Xxxxxx He was conceived of the Holy Spirit and born of the xxxxxx Xxxx. Xxxxx perfectly revealed and did the will of God, taking upon Himself human nature with its demands and necessities and identifying Himself completely with mankind yet without sin. He honored the divine law by His personal obedience, and in His substitutionary death on the cross He made provision for the redemption of men from sin. He was raised from the dead with a glorified body and appeared to His disciples as the person who was with them before His crucifixion. He ascended into heaven and is now exalted at the right hand of God where He is the One Mediator, fully God, fully man, in whose Person is effected the reconciliation between God and man. He will return in power and glory to judge the world and to consummate His redemptive mission. He now dwells in all believers as the living and ...
AUTHORIZATION AGREEMENT FOR AUTOMATIC DEPOSITS. To sign up for EFT, TYPE OR PRINT the information requested in Sections 1 and 2. Then sign, date and return it to HHA. • Any account changes must be reported to HHA ten (10) days prior to actual change. • Payee must keep HHA informed of any address changes in order to receive important information about benefits and to remain qualified for payments.
