[ ] Revision
[ ] Cancellation
All actions above must be
STUDENT DIRECT DEPOSIT AUTHORIZATION
PRINT Name (Last, First, Initial)
NOTE: If student fails to provide complete and accurate information on this authorization form, the processing of the
form may be delayed or made impossible, or the payments may be erroneously transferred electronically.
Student is responsible for verifying all the deposits with his/her bank before he/she issues any checks
against his/her account.
PLEASE CHECK ONE
[ ] CHECKING ACCOUNT [ ] SAVINGS ACCOUNT
Financial Institution Name:
Financial Institution Routing/Transit Number:
• I authorize El Paso Community College to deposit by electronic transfer all monies owed to me to my
account at the financial institution designated above.
• I understand it is my responsibility to notify Accounts Payable at EPCC immediately if I become
aware of any changes in status or banking information or if I believe there is a discrepancy between
the amount deposited directly to my bank account and the amount I am entitled to.
• I understand that it is my responsibility to ensure funds availability with my respective financial institution.
El Paso Community College is not liable for any fees associated with insufficient funds charges.
Steps to Follow:
1. Complete the upper portion of the form, read information, sign and date.
2. Attach a voided check for checking account or a Direct Deposit Enrollment Form from your financial
institution. Do not attach a deposit slip.
3. Submit the completed form to any EPCC Cashier Office at any campus or directly to Data Control at ASC A
Building Room #185.
4. To protect your privacy, you must appear in person to verify your identity by presenting a valid government issued
photo ID, but not limited to driver’s license, other state-issued ID, or passport.
5. Pay notification will be posted on the student’s EPCC Campus Smart Start Network e-mail address.
SIGNATURE DATE
