DIRECT DEPOSIT AUTHORIZATION
Upon completing this form, submit the signed original to Southern Utah University,
Controller’s Office, 351 W. University Blvd., Cedar City UT 84720.
PAYEE CLASSIFICATION
Employee Payroll (Please attach voided check or bank authorization form)
Student or Employee Refund/Reimbursement
Vendor
TRANSACTION TYPE (Check all appropriate boxes.)
New setup
Change financial information
Cancellation
Change account number
Update contact information
Change account type
PAYEE IDENTIFICATION
Social Security number or
Federal Employer’s Identification (FEI) ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___
OR SUU T Number _T_ ___ ___ ___ ___ ___ ___ ___ ___
Name
Phone Number
( )
Email Address (REQUIRED)
Mailing Address
State
ZIP Code
FINANCIAL INSTITUTION
Financial Institution Name
City
State
Routing Transit Number
___ ___ ___ ___ ___ ___ ___ ___ ___
Customer Account Number
___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___
Type of Account
□ Checking □ Savings
Percent/Amount
CANCELLATION
Reason
Date
AUTHORIZATION FOR SETUP, CHANGES OR CANCELLATION
I authorize Southern Utah University (SUU) to deposit payments to my financial institution electronically. I further understand that SUU will reverse any payments
made to my account in error.
I also agree to comply with the National Automated Clearing House Association’s rules and SUU Policies and Procedures for electronic payments at all times.
Authorized Signature
Printed Name
Date
Note:
1) After enrolling in Direct Deposit, all funds specified will be deposited directly to your bank account unless this
agreement is terminated or amended by written notification.
2) It is your responsibility to notify SUU in writing of any changes to your bank account. Your direct deposit will remain
active until you inactivate it with SUU.
3) If funds are direct deposited to your account in error, SUU may initiate a reversal against the account to
recover/remove the funds. If such a case arises, you will be contacted prior to the reversal.
4) SUU is not responsible for any bank or overdraft fees charged to your account.
5) Email notification will be provided prior to the payment posting to your account.
6) Payroll Direct Deposit will be delayed one full pay period if Direct Deposit Authorization forms do not include either
a voided check or bank authorization form.
For vendor or reimbursement questions please contact:
Accounts Payable
Email: accountspayable@suu.edu Phone:
(435) 586-7730 or (435) 586-7964
For payroll questions, please contact:
Human Resources
Email: jobs@suu.edu
Phone: (435) 586-7754