DIRECT PAYROLL DEPOSIT AUTHORIZATION AGREEMENT
(It is Edison’s policy to pay by direct deposit ONLY.)
I hereby authorize Edison Community College to initiate credit entries to my checking or savings account(s) indicated below and the
bank named below (The Bank), to credit the same to such account. I further authorize Edison Community College to debit my
account as necessary to correct a previous credit made in error, provided that Edison Community College shall provide me with
notification of the same. Maximum of (2) two banking institutions allowed for direct deposit of wages.
This authorization is to remain in full force and effect until the Edison Community College Human Resources department has
received written notification from me of any change in my current banking status. Edison Community College will require a 30-day
notification of any such change affecting this agreement.
Pay may not be received as scheduled if this form is not returned prior to 30 days of first pay date.
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Employee Name ___________________________________________Employee ID _________________
Employee Signature ________________________________________ Date _______________________
Primary Bank Information:
Name of The Bank ______________________________________________________________
Please check one: ____ Checking Account
____ Savings Account *confirm routing number with bank for savings account deposit
Account Number:_______________________________________________________________
Routing – Transit/ABA/Number____________________________________________________
Secondary Bank Information:
Name of The Bank _________________________________________
Please check one: ____Checking Account
____Savings Account * confirm routing number with bank for savings account deposit
Account Number:_______________________________________________________________
Routing – Transit/ABA/Number____________________________________________________
Amount $___________ (must be set amount)
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ATTACH A BLANK, VOIDED CHECK(S) OR DEPOSIT(S) SLIP HERE.
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Entered in Datatel by ___________
Date entered ___________
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