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									                         PAYROLL DIRECT DEPOSIT OPTION
       If you want direct deposit, complete below and return to the NH Finance Department
                              Allow (2) two weeks / one complete pay cycle

SCA’s payroll service offers a direct deposit option. Each employee is entitled to request
direct deposits into two (2) savings account and two (2) checking accounts. If you wish
to take advantage of this service, please complete the items below. Actual direct deposits
begin about two weeks after the form is submitted to SCA’s payroll service. Your Bank can provide
you with its ABA number. This is the number which identifies your Bank
as the funds are transferred through the Federal Reserve Bank. It is extremely important
that the bank numbers you provide are correct. Check with your Bank and verify; this is
important if your Bank has recently merged with or by another Bank. Written instructions from you
are required to start the direct deposit option.

I authorize SCA to initiate the following direct deposit to my saving and / or checking
account (s) as soon as possible. I have verified my Bank’s ABA number and my account
number. I have attached a (voided) check (s) for verification of my checking account (s),
and / or a copy of a deposit stub for verification of my saving account(s) and have called
my Bank for verification.

Printed Name:                                       Location / Program:
                         Direct Deposit instructions for CHECKING account (s)
                     (Attach copy (s) of voided check (s) and verify with Bank)

Full Deposit : _______                              Partial Deposit : _____ (complete below if partial)

1. Bank ABA # ___________________________ (Checking Account # 1)

  Employee Account # _____________________Amount $ _____________

2. Bank ABA # ____________________________(Checking Account # 2)

  Employee Account # _____________________Amount $ ______________

                         Direct Deposit instructions for SAVING account (s )

Full Deposit : _______                              Partial Deposit : _____ ( complete below if partial)
                   (Attach copy of Deposit stub(s) and verify with Bank)

1. Bank ABA # _______________________________ (Savings Account # 1 )

  Employee Account # ________________________Amount $ ____________

2. Bank ABA # _______________________________( Savings Account # 2 )

  Employee Account # _________________________Amount $ ___________

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