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HR Rev: 2/18/19 M:\Payroll \Forms\Direct Deposit Authorization Form
DIRECT DEPOSIT
EMPLOYEE NEW HIRE AUTHORIZATION FORM
Last Name First Name (Please Print Clearly)
Note: You must read and sign this document (see other side)
Please complete:
ACCOUNT #1: Primary Account
PLEASE CHECK ONE: New
DISTRIBUTION AMOUNT:
Available Balance (Total pay)
____ Percent Amount (must equal 100% for all accounts. Add 2
nd
account below)
Flat amount of $_________ (Per Pay Period)
If option 2 or 3 is selected, a 2
nd
account must be added OR reminder of balance will be issued in a regular paycheck.
(ie: Flat amount of $50 is selected, any amount remaining pay will be added to 2
nd
account or issued in a regular paycheck)
ACCOUNT TYPE: Checking Account Savings Account
Financial Institutional Name
Routing/Transit Number (ABA) Account Number
ACCOUNT #2: Secondary Account (Optional)
PLEASE CHECK ONE: New
DISTRIBUTION AMOUNT: ____ Percent Amount (must equal 100% for all accounts)
Flat amount of $_________ (Per Pay Period)
Available Balance
ACCOUNT TYPE: Checking Account Savings Account
Financial Institutional Name
Routing/Transit Number (ABA) Account Number
For Checking Accounts For Savings Accounts
Account & Routing numbers can
also be found on in your online
banking or app information
HR Rev: 2/18/19 M:\Payroll \Forms\Direct Deposit Authorization Form
DIRECT DEPOSIT
EMPLOYEE NEW HIRE AUTHORIZATION FORM
Direct Deposit Policy
Purpose:
The Purpose of this policy is to establish the procedures an employee is to follow to have paychecks deposited
directly into an account at a participating financial institution (a financial institution that participates in the
National Automated Clearing House system-NACHA).
Policy:
New Request
The electronic direct deposit program is available to all employees (staff, students, and faculty). If an employee
wishes to have net pay deposited directly into a bank account, he/she may do so by completing the other side of
this document. Current payroll processing and electronic deposit transmitting deadlines allow paychecks funds to
be available for use on payday for both monthly and biweekly employees based on the payroll pay date schedule.
The electronic direct deposit program is for regular payroll runs only and does not include special payroll runs or
manual checks issued.
The authorization form will be processed according to respective payroll and electronic deposit verification
deadlines. Direct Deposit will be in effective after the pre-notification/validation process has been accepted by the
financial institution; therefore an actual paycheck will be generated until the electronic deposit has been activated
by the financial institution, which can take one or more pay periods (normally one). After that period, the
employees will receive a payroll advice as his/her earnings report and acknowledgment of deposit—printing of
advices can be turned-off and available for electronic view by choosing “electronic copies” via the Workday
system.
Changes/Cancellations:
If an employee closes, changes an account or their financial institution, it is the responsibility of the employee to
make the change in their Workday profile. Following the change in Workday, they must stop by the HR office to
sign a payment election change form. In the event a change has been made and the funds are deposited into the
old or incorrect account, the funds must be returned by the employees financial institution before a replacement
check can be issued; failure to notify the payroll department of a change may cause a delay in receiving a payroll
deposit.
Procedures
New Employees who choose to participate in this program will need to complete the Direct Deposit Authorization
form to enroll. This form should be returned to Human Resources on your first day of hire while completing the
onboarding process.
I authorize Pitzer College to direct deposit my payroll check and/or initiate, if necessary, debit entries and
adjustments for any credit entries made in error to my account(s). PLEASE NOTE: If for any reason your bank
account(s) should change or be closed, it is YOUR RESPONSIBILITY to notify the Payroll Office.
I HAVE READ, UNDERSTAND AND AGREE TO THE DIRECT DEPOSIT INFORMATION AS STATED IN THIS DOCUMENT:
Signature Date
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Completed 25 August 2020

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