Meredith College
3800 Hillsborough St
Raleigh, NC 27607 D
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Employee Name: ID #:
Initial sign-up
Change bank or account
Phone number where you may be reached: Stop direct deposit
Add new account to existing accounts
Other:
You may designate more than one account and/or financial institution for your direct deposit. D
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below without written notification to Human Resources to stop or change your direct deposit (you may do so via this form). F
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..
. Complete the information below and attach a voided
check or savings verification form from your bank.
I hereby authorize Meredith College to initiate electronic payroll deposit entries and, if necessary, make adjustments to
reverse any deposits made in error to the account(s) and financial institution(s) indicated below. I acknowledge that the
origination of ACH transactions to my account must comply with the provisions of U.S. law.
Attach Voided check here. Attach Voided check here. -
OR OR -
Attach bank verification form to this form. Attach bank verification form to this form. -
Bank Name:
Amt to Deposit: Total check
and/or Fixed amt $ Balance of check for multiple deposits
Checking
- attach voided check
Checking
- attach voided check
Type of Account:
Savings
– attach verification form
Savings
– attach verification form
This authorization shall remain in effect until the College receives written notification from me of its termination. Notices must be
made in a timely manner so as to afford the College and the financial institution(s) a reasonable opportunity to act upon it (you may
do so in the space provided at the bottom of this form)
.
..
.
Receipt in Human Resources of such notification ten (10) days prior to a
pay date will ensure timely processing.
Employee Signature: ___________________________________________________________ Date: __________________________
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Employee Signature: ___________________________________________________________ Date: __________________________
Payroll Use Only— POSTED:
C: 3/2003 R: 05/2003; 06/2005; 8/2005; 2/2007; 3/2007, 09/2012
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