/ Payroll Direct Deposit Authorization
For New/Rehired Employees: Attach this completed form to the departmental Personnel Action Form (PAF).
For Current Employees: Submit this completed form directly to VCU Payroll Services at P. O. Box842511.
(Please Print) / (Contact your Personnel Administrator for your V-ID #)
Name / V-ID #
Last / First / M.I.
Home / Home Phone
Address / Number
Work P. O. Box / Work Phone / E-mail
Number / Number / Address
Name of Financial Institution (bank or credit union) / Account Type / Checking
(Select only one or will default to “Checking”) / Savings
If you are using avoided check – NOT DEPOSIT SLIP – attach it in this area
sothat VCU Payroll Services can process direct deposit authorization of your paycheck
withyour financial institution. We CANNOT process information using a deposit slip.
Please Note: The document you attach must clearly indicate your account number
and your financial institution’s 9-digit routing transit number.

Below are spaces for you to clearly print account information if you do not have checks.

You may also attach a letter from your financial institution to this form.

Please print the FULL account number as issued by the bank – NOT your member number.

ROUTING: ______

ACCOUNT: ______

Direct deposit/changes should become effective the next available pay periodafter
VCU Payroll Services receives your completed authorization form.

By signing below, YOU…

  • authorize VCU to deposit your net pay amount each payday directly to the selected checking or savings account at the
    financial institution indicated above.
  • Agree to NOTIFY VCU Payroll Services IMMEDIATELY of any changes to this information so that your pay may be properly distributed.
  • UNDERSTAND that, in the event VCU notifies your financial institution you are NOT entitled to the funds deposited to your
    account, your financial institution is authorized to return the deposited amount from your account to VCU.

Signature / Date

By signing above, I attest that (1) the full amount of my direct deposit is not being forwarded to a bank in another country; and (2) if at any point I establish a standing order for my receiving bank to forward the full direct deposit to a bank in another country, I will inform VCU Payroll Services immediately… as directed by the Virginia Department of Accounts & Federal Office of Foreign Asset Control, in support of U.S.C. Title 50, War and National Defense, Oct. 2009.

For PayrollUse Only: Initial______Date______

VCU Human Resources – Payroll Services •P. O. Box 842511 •HR Building - 104 North Belvidere Street •Richmond, VA 23284-2511

Email: •Phone: (804) 828-0740 •Fax: (804) 828-3200 • Web:•Revised October 2014