Name
Department
Employee Pay Reference
(as shown on payslip)
National Insurance number
OLD BANK DETAILS
Old Bank
Old Account Number
(must be 8 digits)
Old Sort Code
(must be 6 digits)
Please change my Bank Details from (date)
NEW BANK DETAILS
Bank Name
Address
Post Code
Account Number (must be 8 digits)
Sort Code (
must be 6 six digits)
Your Signature Date
CHANGE OF BANK DETAILS
This form must be returned by the 15th of the month and will be applied in the month of
receipt e.g. if you want your payment on 31st July to go into your new bank account
then the form must be returned by 15th July.
Please note - We CANNOT accept forms sent by e-mail or fax, only originals will be
actioned as an original signature is required.
Please return this form to:-
Payroll Office
2nd Floor
Tower Building
University of Dundee
DD1 4HN
For Admin Use Only
Photo ID provided: Date
Driving Licence
Changed on P3
Passport
Staff ID Card
E-mail to employee
Other (please specify)
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