N direct Deposit Authorization hr web Site

tarix	26.06.2016
ölçüsü	156 Kb.

N
Direct Deposit Authorization

HR Web Site: http://www.umanitoba.ca/admin/human_resources/
OTE: Direct deposit is mandatory at the University of Manitoba

You must complete a Direct Deposit Authorization form and submit it to Payroll (414 Administration Building) at least eight working days before your first pay day if:

You are a new employee, or
It has been more than six months since you last received a paycheque from the University of Manitoba, or
Your banking information has changed since you last received a paycheque from the University of Manitoba.

Submit a hard copy of this form to Payroll (414 Administration Building), or fax it to 474-7507. Please submit this information as soon as possible in order to prevent a delay in processing your pay.

Questions? For more information, please call Payroll at 474-6632.

November 2013 Version 2013/01

1. Employee Information - MANDATORY

SURNAME:

Department

First Name:

Position Title or Rank:

Name normally used (if different):

Work Phone (if known):

New Hire:

Please provide the start date:

U of M Employee No. (if known):

Re - Hire:

Please provide the start date:

U of M Student No. or SIN

2. Account Information

The following information is required to ensure your paycheque and other payments such as travel and business expense claims are deposited to the correct financial institution and account.
Please attach either a voided cheque or a direct deposit letter from your financial institution.

I am starting direct deposit

I am changing my banking information

For a chequing account with cheques: I have attached a voided cheque.

Include photocopy of cheque if submitting this form by fax.

For other types of accounts (I have attached a letter of direct deposit from my financial institution):

Name of bank, trust company, or credit union:

Institution Code (3 digits)

Transit Number (5 digits)

Account Number (11 or 12 digits)

3. Signature

I authorize direct deposit to the account noted in Section 2.

Signature

Date

Notice Regarding Collection, Use, and Disclosure of Personal Information by the University

Your personal information is being collected under the authority of The University of Manitoba Act. The information you provide will be used by the University for the purposes of maintaining a record of personnel paid, to make reimbursement, to issue income tax receipts and for communication. Your personal information will not be used or disclosed for other purposes, unless permitted by The Freedom of Information and Protection of Privacy Act (FIPPA). If you have any questions about the collection of your personal information, contact the Access & Privacy Office (tel. 204-474-9462), 233 Elizabeth Dafoe Library, University of Manitoba, Winnipeg, MB, R3T 2N2..


FOR CENTRAL ADMINISTRATION USE ONLY
	Info Processed:	Date:

Page of 1 6/26/2016 3:25 a6/p6