Direct Deposit Cancellation Form
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1v1.July.2015
Direct Deposit
Cancellation Form
Payroll Department, 269 Renner Pkwy., Richardson, TX 75080
Phone: (888)703-1316 * Fax: (888)703-1416
Complete information below to stop direct deposit and receive a paper check.
Employee Name:
Employee SSN:
Employee Number:
Co. #:
Loc. #:
Prog. #:
Account Number(s):
Bank Account Type(s):
Checking
or
Savings
Bank(s):
Please cancel deposit to the account(s) listed above. I understand that my
paycheck will be sent to my mailing address currently on file with the Payroll
Department. I further understand that in order to resume direct deposit I will
be required to submit a new Direct Deposit Form to the Payroll Department
in the Richardson FSO.
Employee Signature:
Date:
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Parent category: Business