Missouri Direct Deposit Form 3
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University of Missouri

DIRECT DEPOSIT
Authorization and Order For Payroll Check Direct Deposit in Financial Institution
Employee ID Number

Effective Date

Employee Name (Last, First, Middle Initial)

Home Address (Street, City, State, Zip Code)

The Treasurer of University of Missouri is hereby authorized to deposit my pay into my account identified as and held at the financial
institution identified below, and I certify that such account exists.
This authorization shall remain in effect until I give written notification of any change to my financial institution and/or account
number. I have attached a blank voided check (for deposits to checking account) or deposit slip (for deposits to savings account)

solely for the purpose of verifying my account number and the financial institution's transit number. The voided check or savings
deposit form must include the employee's name preprinted on the form. If this is not the case the employee must sign the voided
check or savings deposit