ContractDirect Deposit Authorization Agreement • June 20th, 2014
Direct Deposit Authorization Agreement COMPANY NAME: Metropolitan State University of Denver COMPANY ID: 84-0559160 I hereby authorize MSU Denver, hereinafter called COMPANY, to initiate credit entries and to initiate, if necessary, debit entries and adjustments for any credit entries in error to myChecking Savings account (select one) indicated below at the depository named below, hereinafter called DEPOSITORY, to credit and/or debit the same to such account. BANK DEPOSITORYNAME: ROUTING NUMBER: ACCOUNT NUMBER: This authorization is to remain in full force and effect until COMPANY has received written notification from me of its termination in such time and such manner as to afford COMPANY and DEPOSITORY a reasonable opportunity to act on it. NAME: SSN: (PLEASE PRINT) Work Teleph Number: one Home Telephone Number: DATE: NOTE: ALL MAY REVOK WRITTEN CREDITE THE AUTHORIZA SIGNED: AUTHORIZATIONS SHOULD PROVIDE THAT THE RECEIVER TION ONLY BY NOTIFYING THE ORIGINATOR IN THE MAN