Revised 04/2020
T
T
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K
E
E
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N
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G
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F
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D
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I
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C
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P
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Y
Y
You can have your pension check deposited into your account without ever having to go to your bank. We can
arrange it through our direct deposit program. Your pension check is credited to your account on payday.
It’s Convenient
You don’t have to worry about getting to the bank because we send your deposit electronically and
provide a payroll statement including your wages, taxes, deductions etc.
It’s Fast
As soon as it’s time for you to be paid, your money is deposited electronically. The delay between
receiving your pay and getting it into your account is eliminated.
It’s Safe
Since there is no paper check to worry about, there’s no chance that it can be lost or stolen.
It’s Free
There is no charge for the service.
If you choose to receive your direct deposit to your bank account, please complete this form and return to the
Pension Office. Email to pensionunit@fultoncountyga.gov for processing!
You must attach a copy of a voided check for a checking account deposit. If you choose a savings
account deposit, documentation from your bank is required as to the correct routing number to
process your direct deposit.
Payroll Deadline: The form must be received in the Finance Department by the 20
th
of the month.
We are pleased to provide this service to our retirees, and we hope you will decide to take advantage of the
convenience, speed and safety of direct deposit of payroll.
NAME:
SSN#:
EMAIL ADDRESS:
PHONE NO.
MY BANK’S NAME:
ALT. PHONE NO.
ROUTING NO. (First grouping of 9 numbers at the bottom of your check)
PLEASE CHECK ONE BELOW:
DEPOSIT TO MY CHECKING ACCOUNT
Voided Check Attached
ACCT. NO.
DEPOSIT TO MY SAVINGS ACCOUNT
Bank Documentation
Attached
ACCT. NO.
I want the convenience and safety of having my pay deposited directly to my bank account each payday. I understand that I
can terminate the direct deposit of payroll arrangement simply by giving written notice, subject to Finance Department
deadlines. I authorize credit entries and any adjustments to be made to my account. I understand that if my account is closed
or changes are made after the payroll deadline, it will result in a delay of my direct deposit payroll funds.
SIGNATURE
DATE
DEPARTMENT OF FINANCE
PENSION DIVISION
141 PRYOR STREET, S.W., SUITE 7001
ATLANTA, GEORGIA 30303
TELEPHONE (404) 612-7606
FAX: (404) 612-1312
click to sign
signature
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