Direct Deposit Authorization Sample Contracts

Contract
Direct Deposit Authorization • April 18th, 2019

UNIVERSITY OF FLORIDADIRECT DEPOSIT AUTHORIZATION PLEASE READ AND CAREFULLY FOLLOW INSTRUCTIONSAll boxes must be completed; do NOT leave any information blank. FORMFOR ONE BANK ACCOUNT Clear PLEASE TYPE OR PRINT CLEARLY payments received by you from the University of Florida. If you want your wage payments to be deposited to more than one account, wait until this initial set up is done and then you can go to My Self Service>Payroll and Compensation>Direct Deposit in myUFL and add up to 2 additional accounts. You do not need to submit a new form when changing departments/positions within the University. AGREEMENTI hereby authorize and request the University of Florida to initiate credit entries and, if necessary, a debit entry in accordance with NACHA rules reversing a credit entry made in error, to my account at the financial institution named. Direct deposit data remains active until one year after separation of employment or until changed by: (a) me in myUFL’s My Self Serv

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Contract
Direct Deposit Authorization • April 1st, 2021

Direct Deposit Authorization Form Client Name: Date: Employee Information (Required) Last Name: First Name: Last Four Numbers of Social: Daytime Phone Number: Reason for Form: New Authorization Changing Account Percentage or Amount On Adding An Account to Current Terminate ALL Direct Deposit Authorizations File Set-up on File and Recieve a LIVE Check Authorization Agreement I hereby authorize the electronic deposit(s) into my designated account(s) listed below. In the event of an error in a deposit, I also authorize the necessary corrective actions to rectify the error, which may include debits and credits. I understand that this authorization is to remain in full force and in effect until I submit a written notification of its termination in such matter to afford such time for all parties to act on it. This authorization is automatically terminated if my employment should cease for any reason. I understand that this authorization may take up to three weeks to fully activate to all

Direct Deposit Authorization Form
Direct Deposit Authorization • March 19th, 2019

Enjoy the convenience of direct deposit by having future payments electronically deposited directly into your bank account. We will email your commission statement to the below indicated email address. I agree to accept payments through electronic funds transfer (EFT) and ensure that you can rely exclusively on the information supplied through this form. This agreement applies to and amends all existing agreements with the entity(ies) checked below. I hereby authorize the entity(ies) noted below to initiate credit entries to and/or debit entries from the financial institution and the account named below.Delta Dental of Virginia Stryden, Inc. Both Stryden, Inc. and Delta Dental of Virginia Agent Information Payee Name Payee Tax ID Address Phone Email Financial Institution Information Checking Account Number Bank Transit/ABA Number Financial Institution Name City State I understand this arrangement will be in effect until I provide notice in writing that I no longer wish to receive funds

First Community Financial Corp.
Direct Deposit Authorization • June 30th, 2017
DIRECT DEPOSIT AUTHORIZATION FORM
Direct Deposit Authorization • December 23rd, 2019
Mohawk Local Schools
Direct Deposit Authorization • April 15th, 2021
Direct Deposit Authorization Form
Direct Deposit Authorization • January 4th, 2011

Before completing this form, read the back and make sure you understand the terms and conditions of the agreement. Fill in the boxes below and sign the form.

Direct Deposit Authorization
Direct Deposit Authorization • February 25th, 2020
DIRECT DEPOSIT AUTHORIZATION
Direct Deposit Authorization • December 23rd, 2015
Important
Direct Deposit Authorization • February 7th, 2023

☑ This authorization is an agreement that remains in effect until payee cancels it or changes it by written notice to the State Retirement Agency (SRA).

Authorization Agreement
Direct Deposit Authorization • May 6th, 2020

This agreement will remain in effect until Rolla Public Schools receives a written notice of cancellation from me or my financial institution, or until I submit a new direct deposit form to the Payroll Department.

Direct Deposit Authorization
Direct Deposit Authorization • June 14th, 2018
DeltaVision®
Direct Deposit Authorization • March 20th, 2019

Enjoy the convenience of direct deposit by having future payments electronically deposited directly into your bank account. We will email your commission statement to the below indicated email address. I agree to accept payments through electronic funds transfer (EFT) and ensure that you can rely exclusively on the information supplied through this form. I agree to accept payments through electronic funds transfer (EFT) and ensure that you can rely exclusively on the information supplied through this form. This agreement applies to and amends all existing agreements with Delta Dental of Virginia and/or Stryden, Inc. I hereby authorize Delta Dental of Virginia and/or Stryden, Inc. to initiate credit entries to and/or debit entries from the financial institution and the account named below. Agent Information Payee Name Payee Tax ID Address Phone Email Financial Institution Information Checking Account Number Bank Transit/ABA Number Financial Institution Name City State This arrangement w

Direct Deposit Authorization Form
Direct Deposit Authorization • May 4th, 2020

Direct Deposit is required for payroll processing. The District also offers the option of electronic transfers (Accounts Payable) to all employees and vendors. Complete this form to enroll in, or make changes to, an existing Direct Deposit/Accounts Payable Account.

1st prenote 2nd prenote Live Date
Direct Deposit Authorization • November 6th, 2008
Authorization Agreement for Automatic Deposits
Direct Deposit Authorization • April 28th, 2016

Please deposit my check directly into the following: (attached is a copy of a voided check for my checking account and savings account.) Your entire check must be direct deposited.

Authorization Agreement For Automatic Deposits
Direct Deposit Authorization • April 27th, 2014

Please deposit my check directly into the following: (Attached is a copy of a voided check for my checking account and a deposit slip for my savings account. If bank is a credit union, I must have a check that includes my account number and the transit ABA number.)

AUTHORIZATION AGREEMENT FOR DIRECT DEPOSITS
Direct Deposit Authorization • February 19th, 2008
Shoshone-Bannock Tribal Membership Per-Capita Only
Direct Deposit Authorization • September 26th, 2024

AUTHORIZATION AGREEMENT: I hereby authorize the Shoshone-Bannock Tribes to initiate credit entries to my account. If necessary, debit entries and adjustments for any credit entries "in error" may be adjusted to my account. This authority is to remain in full force and effect until the Shoshone-Bannock Tribes has received written notification from me of its termination in such time and in such manner as to afford the Shoshone- Bannock Tribes and Depository a reasonable opportunity to act on it. This authorization may be discontinued by completing the Shoshone-Bannock Tribes Direct Deposit Cancellation form or by written notification.

DIRECT DEPOSIT SIGN-UP FORM
Direct Deposit Authorization • November 29th, 2010

SYSTEM INFORMED OF ANY ADDRESS CHANGES IN ORDER TO RECEIVE IMPORTANT INFORMATION ABOUT BENEFITS AND TO REMAIN QUALIFIED FOR

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Employee Direct Deposit or Allocation Authorization Form
Direct Deposit Authorization • January 13th, 2017
Company or Individual Name
Direct Deposit Authorization • July 13th, 2016

hereby authorizes Copper Valley Electric Association (CVEA), to initiate automatic deposits to my account at the financial institution named below. I also authorize CVEA to make withdrawals from this account in the event that a credit entry is made in error.

Direct Deposit Authorization
Direct Deposit Authorization • September 13th, 2007

Agreement Type New Agreement Change Account (please choose one) Employee Information . Employee Name Employer SSN/EEID Home Address Daytime Phone No. ( ) Email address Account Information Reimbursement Plan Type: FSA Tuition Commuter Other I authorize Crosby Benefit Systems to deposit my full reimbursement into my: CHECKING account or SAVINGS account (please choose one) PleaseSIGN Employee Signature Date Complete for Checking Account Only John Doe 12451000 Main St. Date: Please tape a Anytown, USA 11111 V - O - I - Dvoided checkfor checking Pay to the Order Of: $ account. (Donot staple.) PLEASE TAPE A VOIDED CHECK HEREMemo | 123456789 | 00111 11111 | 1245 Complete forSavings Account For Savings Account: Routing/Transit Number: Savings Account Number: Or attach a bank letter with savings routing and account number Submission Information Fax completed forms to:617-928-0001 Or mail to:Direct DepositCrosby Benefit Systems, Inc. PO Box 929125Needham, MA 02492 For Admin Use Only Se

First Community Financial Corp.
Direct Deposit Authorization • March 25th, 2020
AUTHORIZATION AGREEMENT FOR DIRECT DEPOSITS
Direct Deposit Authorization • January 29th, 2008
Authorization Agreement for Automatic Deposits (Ach credits)
Direct Deposit Authorization • March 18th, 2021

This authority is to remain in full force and effect until EMPLOYER has received written notification from me of its termination in such time and manner as to afford EMPLOYER and FINANCIAL INSTITUTION a reasonable opportunity to act on it.

To be completed by Authorized Officer from Department or Chapter**
Direct Deposit Authorization • October 11th, 2018
DIRECT DEPOSIT AUTHORIZATION ABOUT YOUR
Direct Deposit Authorization • May 3rd, 2024
DIRECT DEPOSIT AUTHORIZATION
Direct Deposit Authorization • October 17th, 2014

Employees requesting direct deposit complete and sign the authorization from which the payroll department retains on file. Some employees may wish to have part of their pay deposited into their checking and part deposited into their savings account. If the payroll system is capable of split deposits, offer it to employees to provide even greater freedom in allocating their pay.

AUTHORIZATION AGREEMENT FOR AUTOMATIC DEPOSITS (ACH CREDITS)
Direct Deposit Authorization • August 6th, 2014
Authorization Agreement for Automatic Deposits (ACE CREDITS)
Direct Deposit Authorization • January 18th, 2015
Authorization Agreement for Automatic Deposits (Ach credits)
Direct Deposit Authorization • June 16th, 2020

This authority is to remain in full force and effect until EMPLOYER has received written notification from me of its termination in such time and manner as to afford EMPLOYER and FINANCIAL INSTITUTION a reasonable opportunity to act on it.

Direct Deposit Authorization
Direct Deposit Authorization • October 31st, 2010

This agreement is required to allow GDI to deposit reimbursement payments directly into your bank account (provided your employer and GDI have made this option available).

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