Download Direct Deposit Authorization

Direct Deposit Authorization

Option 1 - Credit entire balance to one account.
Checking Account Number:
at Financial Institution:

Routing #:
Savings Account Number:
at Financial Institution:
Routing #:
Option 2 – Divide as follows:
 exact amount of
or  balance to:
Checking Account #:
at Financial Institution:
Routing #:
 exact amount of
or  balance to:
Savings Account #
at Financial Institution:
Routing #:
 exact amount of
or  balance to:
Savings Account #
at Financial Institution:
Routing #:
Please attach written documentation containing the routing/ABA/Transit number of your
financial institution(s) and your account number(s) such as a voided check or statement
from your financial institution. The first payroll after submitting this form you will receive a live check rather than a direct deposit; you should also receive a trial deposit slip
of a “ghost” deposit to your account.
I hereby authorize Manchester College to initiate credit entries to my account(s) in the financial institution(s) named above, and I authorize the financial institution(s) to accept and to credit the amount of such
entries to my account(s).
In the event that a credit entry is erroneously initiated, I hereby authorize Manchester College to initiate a
correcting debit entry to my account(s). Manchester College will provide to me written notification of such
correction and reason therefore. I authorize the financial institution to accept and to debit the amount of
such entries to my account.
This authority is to remain in full force and effect until Manchester College has received written notification
from me of its termination in such time and in such manner as to afford Manchester College a reasonable
opportunity to act on it and in no event shall it be effective with respect to entries processed by Manchester
College prior to the receipt of notice of termination.
Printed Name: _____________________________
Date:
Signature:__________________________
File #: __________________________