Massachusetts Direct Deposit Form 2
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Direct Deposit Authorization Form

EmplID

HR EmplD __ __ __ __ __ __ __ __

University of Massachusetts – Amherst

our EmplID is 8 digits long. Please write your SSN above only
if you have not yet been paid by the University thus do not
have an EmplID. Thank you.

Name ________________________________________________________________________
Phone ___________________ Email ________________________________________________

Action Requested (Check

One)

Start Direct Deposit

Stop Direct Deposit

Change (add/delete a bank, increase/decrease
fixed amount or select new balance account)

* A change replaces the direct deposit authorization currently on file. Fill in every row of bank information to show how your check should be deposited.

Bank Name

Routing #
__ __ __ __ __ __ __ __ __

Full Deposit
or
Fixed Amount

Checking

(9 digits)

or
Savings

Acct# _____________________

Balance Account
Deposit any balance of net
pay to this account

$____