BISHOP
STATE
BISHOP STATE COMMUNITY COLLEGE
351 NORTH BROAD STREET
MOBILE, ALABAMA 36603
I understand that I will not receive any compensation from Bishop State Community College
unt
il
I have provided the required payroll documentation
to
the Payroll Department in the
Business Office. The documentation,
as
required
by
the
United States Department
of
Justice,
Immigration and Naturalization Service, include a copy
of
your SOCIAL SECURITY CARD
and valid
DRNER'S
LICENSE or
NON
DRIVER'S IDENTIFICATION CARD, etc.
Signature Date
Main Campus
35
1
Nor
th Broad
St
reet Mobile,
Alabama
36603 -5898 (251) 405-7000
Carver Campw;
0
414 Swnron Streec t\fobi/c, Al.
1bama
36617-2399 (251) 662 -5400
Central Campus I 365
Dr.
!vlnrt
in
Luthc:r King./
1:
Avcm1e Mobile,
Alabama
36603-5362 (151) 405-4400
Southwest
Campus
0
925
Da
up
hin Isl.ind
Par/.:lv,1_v
Mobile,
AIJ/Jam.i
36605-3299
(251
) 665-4100
A Member
pf
th
e Afab'm' Community College System
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signature
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'
BISHOP
STATE
BISHOP STATE COMMUNITY COLLEGE
351 NORTH BROAD STREET
MOBILE, ALABAMA 36603
PAYROLL DEDUCTION AUTHORIZATION
CRIMINAL BACKGROUND CHECK
Alabama State Board Policy 623.01 requires a criminal background check for all
employees
of
Bishop State Community College.
I authorize Bishop State Community College Payroll Department to deduct the
amount
of
$17.40 (non-refundable fee) from my paycheck. I understand that the
$17.40
is
non-refundable and my employment
is
contingent upon
an
acceptable
criminal background check.
Print Name
Signature
Date
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BISHOP
STATE
COMMUNITY
COLLEGE
DIRECT
DEPOSIT
PLAN
PARTICIPAITON
AGREEMENT
I,
, authorize Bishop State Community
College
(BSCC)
to
deposit
my
mont
hly payroll
payment
with the bank or fina nci
al
in.stitution
in
dicated
below until
so
notified
in
writing.
Checking Account(S)
Bank/Fin ancial
Institution
Narne: ·
---
....
·-··
--
-
..
- -
*Checking
Account
Numb
er: _ _ ·-
--
__
_
Bank
/Fin;rncial
Institution
Nam
e:
-----
·---
---
-
-----
*Checking Account Number:
____
_
Secondary Checking Account
Amount$
__
_
____
_
Saving
Account(s)
Bank/Financial I
nstitution
Narne:
Bank
Routing Number:
Sav
i
ngs
Account
Number:
Savings
Amount:
CHECK
S
TUB
MAY
BE
REVIEWED
OR
PRINTED
USING
BORfS
*A voided check
or
a legible
chec
k
copy
for this account must
be
attached.
I have read
the
agreements on
this.form
and agree
to
th
e terms contained
there
in
for
BSCC
to
send
payroll
payments due me d
irectly
to
the
above name financial
institution
. I agree that
as
a
condition
to
my participation in
the
direct
deposi
tplan,
BSCC
is authored
to
make
any
nece
ssary
debit
entries
to
this account for any credits
that
were made
in
error and require recovery
of
public funds.
1.
Employee Approval
Type/print employee's
name
as
it
appears
on
Bank records
2.
Joint Ac
count
Approval
Type/print name(s)
of
joint
account
Holder(s)
S
ig
nature of Employee
Signature
*****ATTACH
CHECK
HERE
**
***
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signature
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signature
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