Fillable PLEASE STAPLE YOUR VOIDED CHECK OR DEPOSIT SLIP (Vanderbilt University)

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PLEASE STAPLE YOUR VOIDED CHECK OR DEPOSIT SLIP (Vanderbilt University)

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The PLEASE STAPLE YOUR VOIDED CHECK OR DEPOSIT SLIP (Vanderbilt University) form is 1 page long and contains:

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Country of origin: US
File type: PDF

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Instructions
Please fill out form completely in blue or black ink- Including a signature and date.
Use Additional Forms for Multiple accounts
Attach a voided check or letter from your financial institution- this is a required of all new accounts
PLEASE STAPLE YOUR VOIDED CHECK OR DEPOSIT SLIP IN THE TOP LEFT HAND CORNER
Pay Frequency Weekly Biweekly
Primary Deposit Account
Action: Change Amount/distribution Cancel
OR
Name of Bank
Additional Direct Deposit Account
Action: Change Amount/distribution Cancel
OR
Name of Bank
Percent ______________
Amount ___________
**Signature:
Date:
Add
Account#:
Routing #:
What type of Deposit is this
(Select ONE )?
Checking OR Savings
Percent ______________ Amount ___________
Add
Account#:
Routing #:
Checking OR Savings
What type of Deposit is this
(Select ONE)?
Vanderbilt University Direct Deposit Authorization form
Personal Information - please PRINT
Name :
Employee Or SS #:
I hereby authorize Vanderbilt University to directly deposit my met pay into the bank account(s) as specified. Vanderbilt
is not responsible for any erroneous information provided. I grant my employer the right to correct electronic funds
resulting from an overpayment by debiting my account to the extent of the overpayment. The authorization is to remain
in force until the university has received written authorization from me of its cancellation or change. Please allow two
payroll cycles for your direct deposit to become effective.
Phone Number: Email address:
Monthly
If New or Returning employee-estimated start date:
%
%
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PLEASE STAPLE YOUR VOIDED CHECK OR DEPOSIT SLIP (Vanderbilt University)

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Completed 27 February 2022

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