Authorization for Direct Deposit of Payroll

Authorization for Direct Deposit of Payroll

2 Pages · 2011 · 120 KB · English

University of Wisconsin Service Center Human Resource System Authorization for Direct Deposit of Payroll . The University of Wisconsin System distributes pay using an

Authorization for Direct Deposit of Payroll free download


University of W isconsin Service Center Human Resource System Authorization for Direct Deposit of Payroll The University of W isconsin System distributes pay to the direct deposit accounts you designate below or through the Focus Pay Card. Select One: Biweekly Payroll (Classified/LTE/Student/Unclassified Hourly appointments) Monthly Payroll (Faculty, Academic Staff, Teaching and Research Assistant appointments) Effective Date: As Soon As Possible Future Pay Date: ______________ Employee Information | You are highly encouraged to complete this form online, print, and sign it; or please pr int legibly to prevent delays. Name (Last, First, MI): _____________________________________________________ Pa yroll Empl ID OR Social Security Num ber (Last 4 Digits Only): ________________________ Phone Number: ______________________________________ Email Address: __________________________________________________________________ Primary Account | Required : Your paycheck or the balan ce is deposited in this account after the % or $ amount is deducted from the accounts listed below . Select one: Start Change No Change Account Type (Select one): Chec king Savings ABA Transit Routing Number: Account Number: ______________________________________________________________ Name of Financial Institution: _____________________________________________________ Financial Institution City, State: ___________________________________________________ NET PAY (Balance) Second Account | Optional : Use to designate a percentage or dollar amount for an account other than the primary . % OR $ OF NET DISTRIBUTION Select one: Start Change Cancel No Change Account Type (Select one): Checking Savings ABA Transit Routing Number: Account Number: ______________________________________________________________ Name of Financial Institution: _____________________________________________________ Financial Institution City, State: ___________________________________________________ % or $ Third Account | Optional : Use to designate a percentage or dollar amount for an additional account .

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