Direct Deposit
Authorization
Agreement for Automatic Deposits (ACH Credits)
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Check with your financial institution (bank or credit
union) to see if it is a member of the ACH Network. Community, and
M&T are ACH users.
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If “yes” -ask for the Routing Number as well as the
correct Account Number for the ACH transfer.
You may also want to check on any fees involved. Attach a check
with “VOID” written on it.
You may deposit into three different account #s or banks. If you choose to use more than one bank, Bank 1 should be your primary bank where your net amount will go, and flat amounts can go into one or two other accounts.
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If I am a student, I hereby
authorize
This
authority is to remain in effect until
Signed: _____________________________________ Date: ______/______/______
Print
Name: _____________________________________ SS #: ______-______-______
CWID# _________________ Facutly/Staff ______ or
Student ______ Room Phone: (585) ______-________
Home Phone: (___) ______-_______ Office Phone: (585) ______-________
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Bank 1 - Primary
Bank ------Full Net |
Bank 2 – Flat
Amount -----Partial Net |
Bank 3 – Flat
Amount ----Partial Net |
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Bank Name |
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Bank Telephone Include area code |
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Savings or Checking |
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Amount |
Full
Net minus other bank deposits $ |
$ |
$ |
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Routing # |
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Account #
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New Faculty or Administrator Employees only:
I elect to have my Annual
Salary spread over: _____ 9 _____ 10 _____ 11 _____ 12 months
_____ Initials