Pre-Orientation Checklist
Complete the Form I-9
Complete the Direct Deposit Form
A personal check marked “VOID” with your preprinted name and current address;
A photocopy of a personal check with your preprinted name and current address;
A deposit slip for your savings account PLUS the bank(s) routing number;
An official bank form, certified and stamped by a banking official that provides your account
number and the bank(s) routing number;
Register for your parking pass
Review the mandatory retirement plans
Review the available benefits plans
Complete the W4 and NC Tax Forms
Policy: Direct Deposit is a condition of employment with the University and State of North Carolina under General Statues “G.S. 143B-426.39 and G.S. 143B 426.39B(a) Powers and Duties
of the State Controller” and “NC Administrative Code – 13 NCAC 12.0309 Form of Payment of Wages.” Rev. 8/2018
The completed direct deposit form must be received in the University Payroll Office no less than 15 business days prior to the start of your next pay
cycle for direct deposit to be effective with the associated pay date. Please type or print legibly for accurate payroll processing. Incomplete forms
or forms without an acceptable support document will not be processed for direct deposit pay.
Entry Date:
(Payroll Office Use Only)
ENROLL: Select this box if you are signing up for the first time, or you wish to restart direct deposit for Payroll.
CHANGE: Select this box if you currently have direct deposit and you wish to change your financial account information for Payroll.
SOCIAL SECURITY NUMBER
(LAST 4-DIGITS ONLY)
FIRST NAME
MI
LAST NAME
BANNER ID NUMBER
NCAT.EDU EMAIL ADDRESS
CONTACT PHONE NUMBER
Type of Account
Financial Institution/ Bank Name
Checking Savings
Check and attach the required supporting bank document to this form that list your bank routing and account number. The appropriate
supporting document must be attached for direct deposit entry by the Payroll Office. A direct deposit form submitted without an acceptable supporting
document will not be processed.
a PHOTOCOPY of a CHECK with my preprinted name and current address (starter account checks not accepted)
a CHECK marked “VOID” with my preprinted name and current address (starter account checks not accepted)
a DEPOSIT SLIP with my preprinted name and current address (starter account deposit slips not accepted)
an official BANK FORM, which provides my financial institution's name, list my name, and the routing and account numbers.
I affirm that electronic payments to the designated account must comply with the provisions of U.S. law, as well as the requirements of the Office of Foreign
Assets Control (OFAC). I understand that any electronic payments that may be remitted to me may be labeled with “IAT” (International ACH Transaction) as the
standard entry class. I acknowledge that availability of funds credited to the account will be subject to my receiving financial institution’s policies and procedures.
SIGNATURE:
DATE:
Stop! Please Do Not Write Below This Line
Office Drop-off
Payroll DHR
Yes, employee ID examined/confirmed on _______________ by (FN/LN) __________________________________
Fax (Payroll Only)
Yes, internal security clearance completed by Payroll Director on _____________________________________________________________
U.S. Mail (Payroll Only)
Yes, internal security clearance completed by Payroll Director on _____________________________________________________________
DIRECT DEPOSIT ENROLLMENT AND CHANGE FORM
University Payroll Office
Dowdy Administration Building, Suite 305
1601 East Market Street
Greensboro, NC 27411
Office: 336.334.7888 Fax: 336.256.0801
Policy: Direct Deposit is a condition of employment with the University and State of North Carolina under General Statues “G.S. 143B-426.39 and G.S. 143B 426.39B(a) Powers and Duties
of the State Controller” and “NC Administrative Code – 13 NCAC 12.0309 Form of Payment of Wages.” Rev. 8/2018
How To Complete and Submit the Direct Deposit Enrollment and Change Form
Important Facts You Need to Know
Each section of this form must be completed accurately as required for processing. Forms received missing essential information will not be
processed for direct deposit pay.
This form contains confidential and sensitive information; therefore, in accordance to the university policy for data security, and compliant
with federal and state regulations, the Payroll Office will not open or process an emailed direct deposit form.
Faxed and mailed direct deposit forms is subject to a security clearance process to safeguard your employee and banking information.
How To Complete
1. Enroll: Check this box if you are signing up for direct deposit for the first time or if you are returning to the University after a break in service
greater than one year.
2. Change: Check this box if you currently have direct deposit set-up and you wish to change your financial account information for payroll
processing.
3. Social Security Number Last 4 Digits Only: Enter the last four digits of your social security number. Do not list your full number.
4. Banner ID Number: Enter your university assigned nine-digit Banner identification number.
5. First Name: Enter your legal first name.
6. MI: Please enter your legal middle name, as applicable.
7. Last Name: Enter your legal last (surname) name.
8. NCAT.EDU Email Address: Enter your ncat.edu email address as a source of contact, in the event, there are questions regarding the direct
deposit enrollment and change form.
9. Contact Phone Number: Enter your direct contact number (area code and seven-digit phone number) as a source of contact, in the event,
there are questions regarding the direct deposit enrollment and change form.
10. Banking Information: Please read this section carefully.
a. You should immediately notify the Payroll Office if there is a change in your banking information or if your bank account is closed.
11. Type of Account: Check if the deposit account is considered checking or savings. Direct deposit is specific to deposit accounts set-up as a
checking and/or savings. Returned direct deposits are subject to deactivation of account for payroll processing.
12. Financial Institution/Bank Name: Enter the name of the financial institution or bank name in which your deposit account is secured.
13. Deposit Account Support Information (REQUIRED): Check the appropriate box that supports the deposit account listed in the Banking
Information section of the form.
a. Deposit forms submitted without valid supporting documentation will not be processed for direct deposit pay.
b. We do not accept starter account checks or savings deposit slips that do not list your preprinted name, current address, bank name,
and a check number; along with the routing and account numbers.
c. An official” bank form must contain the name of the financial/banking institution, your name, and routing number and account
numbers.
i. If you elect to use a bank generated direct deposit authorization form as your supporting document, you must complete
each section of the form, to include your signature and date for authorization.
ii. Important Note: Submitting the financial institution or bank generated direct deposit authorization form as a supporting
document does not eliminate the requirement to complete the Direct Deposit Enrollment and Change Form for North
Carolina A&T State University (employer).
14. Skip the next check box if you will not transfer deposited funds outside the U.S.
a. IRS federal regulations require that you disclose and confirm if you will transfer your entire electronic payment from your U.S. bank
account to a foreign bank account (to another country).
i. If you do not plan to transfer funds outside the U.S., please skip this section.
ii. If you plan to do so, you must read the statement and check the “I affirm” box.
15. Authorization Agreement: Please read carefully. By signing this agreement, you authorize the University and UNC Shared Services Center to
initiate direct deposit entries each pay period. You also agree that if the payroll transmission fails, due to incorrect or outdated banking
information you provided, that you will not receive a replacement payment until AFTER a full refund is received from the financial institution.
You further accept the terms and conditions of the University direct deposit program as outlined in the agreement statement. You further
acknowledge that NC A&T has the right to retract and correct payments, as required to avoid an overpayment of funds not due to you.
16. Signature/Date: You must sign and date this form to authorize deposit. Digital or electronic signatures are not acceptable and will result in
the return of this form to you unprocessed.
How to Submit to Payroll
You may drop-off the form to the Payroll Office located in the Dowdy Administration Building, Suite 305. You must present a valid and legal
identification document that includes your name and photo for identity confirmation.
You may return the form by fax to 336.256.0801. If faxed, you will receive a courtesy phone call from Payroll for identity security clearance.
You may mail the form through U.S. postal mail services to the University Payroll Office, Dowdy Administration Building Suite 305, 1601 East
Market Street, Greensboro, NC 27411. If mailed, you will receive a courtesy phone call from Payroll for identity security clearance.
Questions? Please contact us at 336-334-7888.