Direct Deposit of Payroll Authorization



To: UNIVERSITY OF THE VIRGIN ISLANDS



Human Resources Department



I authorize you to deposit my net pay automatically to may account specified below

each payday by initiating credit entries to my account electronically or by any other

commercially accepted method, and I authorized the financial institution named

below to credit the same to my account. If funds to which I am not entitled are

deposited to my account, I authorized you to direct the financial institution to debit

the same to my account. This authority will remain in effect until you have received

written notice from me of its cancellation in such time and manner as to afford you

and the financial institution a reasonable opportunity to act on it.



Attach a voided check to this authorization form.



Please print



Financial Institution Eeoplayes Name

Branch Address Signature



City State Zip Date



Account Title Employee [ID Number



L | | | | | | | | | ft |



Transit Routing Number



[|] | | | | | | | tT ft 4



Account Number



Account Type: CHECKING OR SAVINGS



REVISED 02/2015