To: All Employees
From: Controllers Office
Re: Direct Deposit
Date:
Direct Deposit is now available for all employees. With Direct Deposit you can automatically deposit all or part of your pay
in up to three different accounts (including checking, savings and IRA) at the financial institution of your choice. By having
your pay automatically deposited you:
Have your pay in your account on payday, without going to the bank.
Stop the possiblity of lost, stolen or destroyed checks.
Save time making trips to the bank to cash or deposit your check.
Will still receive a pay statement displaying your earnings and deductions.
If you would like to sign-up for Direct Deposit, please return the bottom portion of this form, along with a
voided check or bank spec
for the account(s) you wish to deposit your money. (Note: no deposit slips)
Authorization Agreement for Automatic Direct Deposit
I hereby authorize Medical Center Eye Clinic hereinafter referred to as "Company" to initiate
credit entries for sums to and payable to me to my checking, savings or other account indicated below and the Financial Institution
named below, hereafter referred to as "Depository" to credit the same to such account. I also authorize Company to initiate debits for
sums due to the Company for erroneous deposit or deposits at the Depository.
Bank Name
Bank Transit ABA No.
Bank Account No.
Amount or Percentage
Checking:
Savings:
Debit Card:
Other:
This authorization is to remain in full force and effect until Company has received notification from me of its termination
in such time and in such manner as to afford Company a reasonable opportunity to act on notification or until such time as
Company terminated this agreement.
