DEPARTMENT OF FINANCE 
GOVERNMENT OF THE VIRGIN ISLANDS OF THE UNITED STATES VIRGIN ISLANDS 
DIRECT PAYROLL DEPOSIT AUTHORIZATION 
 
 
Name: 
 
Social Security #: 
 
Department / Agency: 
 
Employee Number: 
 
 
I hereby authorize the Government of the Virgin Islands Department of Finance to directly 
deposit my bi-weekly net pay to the following: 
 
Checking Account Number: 
 
Routing Number: 
 
 
 
(Name of Financial Institution) 
Savings Account Number:  
 
Routing Number: 
 
 
(Name of Financial Institution) 
 
I understand that this authorization may be terminated by me upon two (2) weeks’ notice to the Department of 
Finance, Payroll Division.  I further understand that, as a Direct Payroll Deposit Participant, I will receive a 
statement of earnings (i.e. Direct Deposit Advice) for all paychecks. 
 
 
 
 
 
 
Signature 
 
 
 
Date 
 
 
 
Note: The Department of Finance (“the department”) will be operating as your agent for the Direct Payroll Deposit, 
not as an agent of the depository Institution named above.  The department, therefore, does not accept responsibility 
for any negligence on the part of said depository institution. 
SIGN