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Walton County Board of Commissioners Employee Direct Deposit Form Authorization Agreement for Automatic Credits (ACH Credits) Please Print Legibly Employee Information Full Name: Last 4 of SSN: Address: City, State, Zip: Phone Number: Account 1 Information Financial Institution: Routing Number: Account Number: Account Type Checking Savings Percentage of Check to deposit: Account 2 Information Financial Institution: Routing Number: Account Number: Account Type Checking Savings Percentage of Check to deposit: *A voided check, Direct Deposit Form from your banking institution, or a bank issued letter with your account information is required. *If this is a joint account, all people listed on the account must sign below. *Direct deposits may take up to two pay cycles to process and verify. You will receive a cashable paper check until the direct deposit is approved. ---PAGE BREAK--- I (we) hereby authorize Walton County Board of Commissioners, hereinafter called WC Payroll, to initiate Credit entries and initiate, if necessary, credit entries and adjustments for any debit entries in error to my (our) checking account indicated below and the depository named below, hereinafter called DEPOSITORY, to credit and/or debit the same to such account. This authority is to remain in full force and effect until WC Payroll has received written notification from me of its termination in such time and in such manner as to afford WC Payroll and DEPOSITORY a reasonable opportunity to act on it. Name(s): Date: Signature(s): WARNING: If you close your account before you stop direct deposit, NO REPLACEMENT CHECK WILL BE ISSUED until the money is returned by your bank to Walton County’s bank account. This may take several days. You must stop your direct deposit first, before closing your bank account!!!!! After today, you will continue to receive a regular paycheck until the prenote clears. This process generally takes two pay periods to complete. After the prenote clears, you will get a non-negotiable stub and the money will be deposited directly into your bank account the following pay date. This will continue until you give written notice to WC Payroll to stop. WC Payroll must receive your written notice no later than 10 days before the next pay period to stop your direct deposit. I (we) understand the warning above as well as when my bank account will reflect the direct deposit. I (we) agree to give written notice to payroll to stop my direct deposit before I (or either of us) close this account and that it is solely my responsibility and not that of Walton County BOC. (EACH PERSON MUST SIGN IF JOINT BANK ACCOUNT): Name(s): Date: Signature(s):