for Electronic Deposits
Name: ____________________________________ Social Security Number: xxx-xx- _______
Employee Number: ______________________
CITY OF BANK
ACCOUNT NUMBER AMOUNT
• Bank Routing Number is the ﬁrst group of numbers at the bottom of check.
• If depositing funds to more than one account, please indicate amount to be deposited to ﬁrst
account and indicate “remainder” to be deposited to second account.
I authorize Durham Technical Community College to deposit my net pay to the bank and account
Signature: _________________________________________________ Date: __________________
Attach voided check or account verification from bank to this form.
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