Common Contracts
2 similar Authorization Agreement for Automatic Deposits (Ach Credits) contracts
ContractAuthorization Agreement for Automatic Deposits (Ach Credits) • December 19th, 2018
Exhibit 20.20.21 Rev. 2018 AUTHORIZATION AGREEMENT FOR AUTOMATIC DEPOSITS (ACH CREDITS) EMPLOYEE NAME: EMPLOYEE SSN: I hereby authorize the State of Mississippi to initiate credit entries and to initiate, if necessary, debit entries and adjustments for any credit entries in error to my account indicated below and the depository named below, hereinafter called Depository, to credit and/or debit the same to such account. ABA TRANSIT NO: ACCOUNT NO: ACCOUNT TYPE CHECKING SAVINGS DEPOSITORY NAME PERCENT OF PAYROLL DEPOSITED: BEGIN DATE: This authority shall remain in full force and effect until the Agency has received written notification from me (or either of us) of its termination in such time and in such manner as to afford the agency and depository a reasonable opportunity to act on it. EMPLOYEE SIGNATURE PLEASE CIRCLE ADD CHANGE DELETE - END DATE ATTACH VOIDED BLANK CHECK OR COPY OF CHECK JANE DOE 1000 MAIN STREET ANYWHERE, U. S. A. 10001 PAY
ContractAuthorization Agreement for Automatic Deposits (Ach Credits) • December 19th, 2018
Exhibit 20.20.21 Rev. 2018 AUTHORIZATION AGREEMENT FOR AUTOMATIC DEPOSITS (ACH CREDITS) EMPLOYEE NAME: EMPLOYEE SSN: I hereby authorize the State of Mississippi to initiate credit entries and to initiate, if necessary, debit entries and adjustments for any credit entries in error to my account indicated below and the depository named below, hereinafter called Depository, to credit and/or debit the same to such account. ABA TRANSIT NO: ACCOUNT NO: ACCOUNT TYPE CHECKING SAVINGS DEPOSITORY NAME PERCENT OF PAYROLL DEPOSITED: BEGIN DATE: This authority shall remain in full force and effect until the Agency has received written notification from me (or either of us) of its termination in such time and in such manner as to afford the agency and depository a reasonable opportunity to act on it. EMPLOYEE SIGNATURE PLEASE CIRCLE ADD CHANGE DELETE - END DATE ATTACH VOIDED BLANK CHECK OR COPY OF CHECK JANE DOE 1000 MAIN STREET ANYWHERE, U. S. A. 10001 PAY
