DIRECT DEPOSIT AUTHORIZATION FORM
All faculty and staff are required to make direct deposits into their checking and/or savings accounts for their net pay and
payments issued by ORU Accounts Payable for travel and refunds via ACH processing. To add new account(s) or to
enroll for the first time, complete this form and attach a voided check from your checking and/or deposit slip from your
savings account. Return all items to the Payroll Department.
Funds for payroll will be available in your account on payday. Multiple payroll distributions are allowed. For more than
two (2) accounts (limit of 4 accounts) fill out an additional form, using the space designated Bank #2.
All forms received after the payroll deadline will be processed the following pay period. If you have questions, please
call Becki Beyer, Payroll Manager at 918-495-7551.
AUTHORIZATION AGREEMENT FOR DIRECT DEPOSIT – BANK #1 – Remainder of NET PAY
COMPANY NAME: ________________________________________________ I HEREBY AUTHORIZE MY EMPLOYER,
THE COMPANY NAMED ABOVE, TO DEPOSIT MY NET PAY AND/OR ORU ACCOUNTS PAYABLE TO MY
ACCOUNT IN THE BANK DESIGNATED BELOW. I AUTHORIZE THE BANK TO ACCEPT AND TO CREDIT THE
AMOUNT OF THAT ENTRY TO MY ACCOUNT VIA:
Direct Deposit to:
BANK /FINANCIAL INSTITUTION NAME: ________________________________________________________
CITY: _________________________________ STATE: ______________
BANK ROUTING # ______________________________ ACCOUNT# _____________________________
CHECKING ____________________________ OR SAVINGS
_______________________________
EMPLOYEE NAME: _________________________________________ Z # ______________________
DATE: __________________ SIGNED: ____________________________________________________
* A CHECK MARKED “VOID” MUST BE ATTACHED TO THIS FORM FOR PROCESSING
AUTHORIZATION AGREEMENT FOR DIRECT DEPOSIT TO: – BANK #2
Specific Dollar Amount - $
________________________
Percentage of Net Pay - %
________________________
I HEREBY AUTHORIZE MY EMPLOYER, AS NAMED ABOVE, TO DEPOSIT PART OF MY NET PAY, AS
INDICATED TO THE BANK NAMED BELOW. I AUTHORIZE THE BANK TO ACCEPT AND TO CREDIT THE
AMOUNT OF THAT ENTRY TO MY ACCOUNT.
BANK/FINANCIAL INSTITUTION NAME: _________________________________________________
CITY: _________________________________ STATE: ______________
BANK ROUTING# ______________________________ ACCOUNT# _______________________________
CHECKING _______________ OR SAVINGS
________________
EMPLOYEE NAME: __________________________________________________Z # ________________
DATE: __________________SIGNED:_______________________________________________________
*ATTACH A “VOID” CHECK (IF CHECKING). REMINDER: All company property must be returned to Human
Resources on or before the last day of work.
