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FINANCIAL AID / ACCOUNTS PAYABLE
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Printed Name Signature
This agreement will remain in effect until Umpqua Community College receives a written notice of cancellation from me or my
financial institution, or until I submit a new direct deposit form to the Finance Office. Please allow the College ten business days for any
changes to this information.
I hereby authorize Umpqua Community College to deposit my financial aid/accounts payable funds into my account at the bank
named above. Umpqua Community College is authorized to reverse any deposits made in error to my account through the college's direct
deposit program. I further warrant that I am a holder on the account listed above.
Finance Office Use: Id verified
Student Direct Deposit Authorization Form
Financial Aid & Accounts Payable Disbursements
person,totheFinanceOfficelocatedinLAVERNE MURPHY Student Center, 1140 Umpqua
CollegeRd,Roseburg, OR 97470.
Student Banner ID number (required)
Further, I agree not to hold Umpqua Community College responsible for any delay or loss of funds due to incorrect or incomplete
information supplied by me or by my financial institution or due to an error on the part of my financial institution in depositing funds to my