COMPTROLLER'S OFFICE
ALABAMA A&M UNIVERSITY | Business Office
Request Type:
New
Name:
Banner ID:
Last four digits of SSN (for new employees):
Account #1 - Percentage Account Type
Check here if you are only changing the percentage
Bank/Financial Institution:
Routing Number: Account Number:
Account #2 - Percentage Account Type
Check here if you are only changing the percentage
Bank/Financial Institution:
Routing Number: Account Number:
Signature: Date:
Account Information
Please deposit the indicated percentage of my check into one of the following and the remainder into the other account.
Direct Deposit Enrollment For
Authorization Agreement
I hereby authorize Alabama Agricultural and Mechanical University to direct deposit all my payments to my financial institution(s)
listed below until I terminate this agreement in writing. A terminated or new agreement shall become effective within the next two
pay periods following receipt of this form.
In the event that funds are erroneously deposited into my account(s), I authorize Alabama Agricultural and Mechanical University or
the depository institution to debit my account(s) for the purpose of correcting the error.
I acknowledge that:
(1) It is my responsibility to verify my account balance prior to making disbursements or withdrawals.
(2) Alabama A&M University assumes no liability for bank errors, bank fees, or overdrafts.
(3) Deposit rejections will not be reprocessed until funds have been redeposited into the University's account.
(4) A new authorization must be completed when changing accounts or financial institutions, or when closing an account.
(5) If I have not provided a voided check or direct deposit authorization form from my financial institution,
I take full responsibility for delays and/or charges to my account that may be the result of providing
incorrect information.
I certify that the information provided on this form is correct and that I am authorized to execute this document.
REQUIRED: To ensure the account information provided is valid, please attach a voided check or a direct deposit
authorization form from your financial institution with account, account type, and routing information.
Change
Termination
Checking
Checking
Savings
Savings
Business Office Use Only
Completion Verification
Payroll:
A/P:
Phone:
Email:
*** Splitting direct deposits is only available for PAYROLL. If more than one account is listed below, all
non-payroll deposits will be made into the first account listed below. ***
Revised 08/17/2015
