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PAYROLL DEDUCTION DIRECT DEPOSIT AUTHORIZATION

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Clear Form PAYROLL DEDUCTION DIRECT DEPOSIT AUTHORIZATION . (Choose ONE of the following Options). For security purposes, we can only accept ORIGINAL forms - - NO FAXES, NO E-MAILS. ________________________________________ ____________ ________________________ ___X X X X X -________________. Employee Name: (Last) (First) ( ) Employee No. Social Security No. (last 4 digits ONLY). ________________________________________ ________________________________________ ______________________________. Address City State Zip OPTION 1 - ____ Financial Institution: By signing below, I hereby authorize the Miami-Dade County School Board and the financial institution listed below to automatically DEPOSIT my net pay to: Bank Name ________________________________________ ___________ Routing/Transit No. ____________________________________. Check One: ______ Checking ______ Savings Account No. ________________________________________ __. TAPE YOUR VOIDED CHECK HERE (Please DO NOT staple voided check!)

PAYROLL DEDUCTION DIRECT DEPOSIT AUTHORIZATION (Choose ONE of the following Options) For security purposes, we can only accept ORIGINAL forms - - NO FAXES, NO E-MAILS.

  Direct, Authorization, Deposits, Payroll, Deduction, Payroll deduction direct deposit authorization

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