Illinois Direct Deposit Form 2

Illinois Institute of Technology Direct Deposit Authorization Form
Name: _____________________________________________ Banner ID: _____________________________
Employing Department: __________________________ Email Address: ______________________
I hereby authorize Illinois Institute of Technology Payroll Services to:
START New Direct Deposit
STOP All Direct Deposit
CHANGE my Direct Deposit as follows:
Change all (a change replaces all currently active direct deposit allocations). Fill in each
line of bank information to show how your check should be now.
Add new account(s) (existing accounts will remain unchanged).
Remove account(s) (other accounts will remain unchanged). You MUST have a primary account.
Change amount to be deposited into secondary account.
All new account(s) setups must have attached a voided check or documentation from the bank showing the Bank
Routing Number and the actual Account number. If these documents are not attached, the verification of the
banking information may take up to two pay periods provided there are not errors returned on your account and
your account will “pre-note” and your check will be mailed to your permanent address during the pre-note process.
Once direct deposit becomes active, your pay stub can be viewed and printed through Banner Self Service.
____________________________________________________________________________________________
Primary Account (Required): The amount of deposit to the Primary Account is your net pay less any direct deposit to
the secondary account(s) listed below:
Bank Name: ________________________________________________
100 % of Net Pay
Checking: / Savings:
(attach voided check or other bank info )
Bank Routing Number: ___ ___ ___ ___ ___ ___ ___ ___ ___ Account Number: ___________________________
(MUST be 9 digits)
______________________________________________________________________________________________
Secondary Account for Deposit (Optional):
Amount to be deposited each pay period: $ _____________
OR
PERCENT OF NET PAY: _________ %
Bank Name: __________________________________________________
Checking:
/ Savings:
(attach voided check or other bank info )
Bank Routing Number: ___ ___ ___ ___ ___ ___ ___ ___ ___ Account Number: ___________________________
(MUST be 9 digits)
I hereby authorize Illinois Institute of Technology, hereafter called IIT, to initiate credit entries and to initiate, if necessary debit
entries and adjustments for any credit entries in error to my account(s) indicated above.
I understand that it is my responsibility to verify that payments have been credited to my account(s) and that the University (IIT)
assumes no liability for overdrafts for any reason. I understand that in the event my financial institution(s) (BANK) is/are not
able to deposit any electronic transfer into my account(s) due to any action I take, the University (IIT) cannot issue the funds to
me until the funds are returned to the University (IIT) by the financial Institution(s) (BANK).
I understand this authorization will override any previous authorization and will remain in effect until revoked by my written
request. I understand that I must immediately notify Payroll Services before I close any/all account(s) listed above while this
authorization is in effect.
Send completed forms to: Illinois Institue of Technology Payroll Office, 3300 S. Federal Room 205, Chicago, IL 60616
Signature: __________________________________________ Date: _____________________________________
IIT DDF AUTH FORM 032009