Payroll Electronic Direct Deposit EDD Refusal Revocation Deposit Advice Change by redheadwaitress

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									                                 Payroll Electronic Direct Deposit (EDD)
                            Refusal/Revocation & Deposit Advice Change Form

                                 Faculty/AP Staff/Grad/Undergrad/Civil Service


                                                                I am paid as:      Monthly Faculty/AP Staff/Grad/Undergrad
                                                                                   Semi-monthly Civil Service
                                                                                   Bi-weekly Civil Service



EDD Refusal/Revocation (check one)

__________ I do not want to participate

__________ Please cancel my participation

By not participating in EDD, I agree to pick up my paycheck at the Account’s Payable Office - 108 Miles Hall,
1st Floor, (Greek Row) on, or after, payday between 8:00 am and 4:30 pm.



_________________________                    ____________________________________________________
   Social Security Number                                        Employee’s Name


________________________________________________                          _________________
             Employee’s Signature                                              Date




Deposit Advice Change (check one)

________    Please cancel my Deposit Advice.

________    I want a Deposit Advice sent to my current campus address. (NOTE: I understand the Deposit
            Advice is available to me only if I am participating in electronic direct deposit (EDD).



________________________                     ____________________________________________________
  Social Security Number                                          Employee’s Name


____________________________________________________                      __________________
                 Employee’s Signature                                           Date

                Payroll Office, Mailcode 6820, Carbondale, Illinois 62901-6820, 618/453-3391, Fax: 618/453-3453

                                                       Revised Oct 2007

Form: pao0103

								
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