wvOASIS PAYROLL DIRECT DEPOSIT CHANGE FORM INSTRUCTIONS
To process a Payroll Direct Deposit Change request the employee must do the following:
1. Provide First and Last Name
2. Provide wvOASIS Employee ID - (Can be provided by your payroll department.)
3. Provide Social Security Number
4. Complete, Sign, Date the form and Print your name below the signature.
5. Deliver the form with your account documentation to your State Agency Payroll Department for completion.
Payroll Primary Account
1. To Change Account Information From, list the name of the Bank your net pay is currently being
deposited as well as the Routing and Account number. Indicate whether the account is a checking or
savings. To help prevent a delay in receiving your pay, do not close your old account until you
have received a payment in the new account.
2.
List the name of the new Bank to which your funds will be deposited as well as the Routing and Account number.
3. Indicate whether the account is checking or savings. Please select one box ONLY!
a. Checking
Attach a voided check, Financial Institution statement, or a letter from the Financial
Institution (on FI letterhead) listing the account information, printed name, and
signature of the Financial Institution representative, title and contact information.
b. Savings
Attach a Financial Institution statement or letter from the Financial Institution
(on FI letterhead) listing the account information, printed name, and signature of the
Financial Institution representative, title and contact information.
Payroll Secondary Account(s)
1. List the name of the Bank your secondary amount is currently being deposited as well as the Routing, and
Account number.
2. List the current dollar amount that is being deposited to your secondary account.
3. Indicate whether you want to Change Account Information From or Change Amount Only. Please select one
box ONLY!
4. If you want to change your current secondary account on file, please select the Change Account Information
From box.
5. If you want to keep the same account and change the dollar amount select the Change Amount Only box.
6. If you select the Change Account Information From box, you must list the new Bank Name, Routing and
Account Number as well as the dollar amount under the Change Account Information To section.