!
!
Work-Study Direct Deposit Authorization
!
!
Name
Student ID#
Bank Name
Bank Routing Number
Account Number
Account Type: Checking Savings Debit/Credit Card
I authorize Coahoma Community College and the bank listed to deposit my net pay
electronically to my
account each payday. If funds which I am not entitled to are deposited to my account, I authorize
Coahoma Community College to direct the bank to return said
funds. This authority will remain in effect
until I have filed a new authorization.
Authorization Type: New Change Cancel
!
!
!
!
Authorized!Signature!
!
!
!
!
!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!Date
!
!
!
!
!!
!!!!!!!!!!!!!!!!!!!!!!