Fillable SALT LAKE COMMUNITY COLLEGE PAYROLL/ACCOUNTS PAYABLE DIRECT DEPOSIT (Salt Lake Community College)

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SALT LAKE COMMUNITY COLLEGE PAYROLL/ACCOUNTS PAYABLE DIRECT DEPOSIT (Salt Lake Community College)

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The SALT LAKE COMMUNITY COLLEGE PAYROLL/ACCOUNTS PAYABLE DIRECT DEPOSIT (Salt Lake Community College) form is 1 page long and contains:

  • 1 signature
  • 15 check-boxes
  • 19 other fields

Country of origin: US
File type: PDF

U.S.A. forms for Salt Lake Community College

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SALT LAKE COMMUNITY COLLEGE
PAYROLL/ACCOUNTS PAYABLE DIRECT DEPOSIT AUTHORIZATION FORM
For deposits into a checking account, YOU MUST ATTACH a “VOID” check. For deposits into a savings account, YOU MUST
ATTACH a letter from the financial institution with the bank routing number and your account number. We CANNOT accept
deposit slips.
Print Name:___________________________________
Employee S# or SSN:_______________________________
Check one of the following:
☐
New: Deposit my pay and/or reimbursements to the financial institution and account(s) shown below. I am not currently
participating in the direct deposit plan.
☐
(current financial institution) to the financial institution and
Change: Please change my direct deposit from _____________
account sh
own below.
☐
Cancel: Please stop my participation in the program. My check will be mailed to my address on file.
Payroll
Name of Financial Institution (1st Acct)
Check one:
Routing Number
Checking
☐
Account Number
Savings
☐
% or $ amount to this account
(Optional- USE ONLY IF NOT 100% IN 1
st
ACCOUNT)
Name of Financial Institution (2nd Acct)
Check one:
Routing Number
Checking
☐
Account Number
Savings
☐
% or $ amount to this account
Name of Financial Institution (3rd Acct)
Check one:
Routing Number
Checking
☐
Account Number
Savings
☐
% or $ amount to this account
Accounts Payable - One Account Only Same as Payroll
☐
Name of Financial Institution
Check one:
Routing Number
Checking
☐
Account Number
Savings
☐
% or $ amount to this account
100%
I hereby authorize Salt Lake Community College and the financial institution (s) shown on this form to deposit my net pay and/or my
reimbursements directly to my account and to initiate, if necessary, debit entries and adjustments for any SLCC deposit entry made in error to my
account. This authority will remain in effect until I file a new authorization form. It is my responsibility to turn in correct information and to read
this entire form.
Employee Signature: _____________________________________________________________ Date:__________________________
Remittance notification: You will receive an email sent to your Bruinmail or Outlook account each payroll or reimbursement with an
attached .pdf.
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SALT LAKE COMMUNITY COLLEGE PAYROLLACCOUNTS PAYABLE DIRECT DEPOSIT (Salt Lake Community College)

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Completed 12 August 2021

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