Fillable Direct Deposit Request Cancellation (New Mexico Institute of Mining & Technology)

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Direct Deposit Request Cancellation (New Mexico Institute of Mining & Technology)

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Direct Deposit Request
Cancellation
Name: _______________________________________________________________________
Social Security or Banner Number: _____________________________________________
Date: __________
Current Direct Deposit Bank to be cancelled: ________________________________________
Account # ____________________________
Please Cancel my direct deposit and route my check as follows:
Cashiers’ Window __________
Department _______________
(Bureau, EMRTC, Playas, IERA, or Facilities Management only)
________________________________________ __________
(signature) (date)
PD0003 Revised date: 4 December 2007
Payroll Use Only:
Entered By:
Verified By:
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Direct Deposit Request Cancellation (New Mexico Institute of Mining & Technology)

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Completed 24 August 2020

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