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Direct Deposit Agreement Form

Authorization Agreement
I hereby authorize York Technical College to initiate automatic deposits to my account at the financial institution named below. I also authorize York Technical College to make withdrawals from this account in the event that a credit entry is made in error. I realize that I will not be issued a pay advice, but will be given access via Campus Cruiser where I may view my payroll history. Further, I agree not to hold York Technical College responsible for any delay or loss of funds due to incorrect or incomplete information supplied by me or by my financial institution or due to an error on the part of my financial institution in depositing funds to my account. This agreement will remain in effect until York Technical College receives a written notice of cancellation from me or my financial institution, or until I submit a voided check form to the Payroll Department.
Account Information
Name of Financial Institution:
Routing Number:	(Bottom of check or deposit slip)
Account Number:	(Bottom of check or deposit slip)	Checking		Savings
Signature
Authorized Signature:			Date:
Printed Name
CID # ___________ Please attach a voided check and return this form to the Payroll Department. Direct Deposit forms must be received by the 15^th of any month in order to be deposited into your account the following month. Please call Julie O’Dell at ext 7022 with questions or concerns.