PLEASE READ THIS CAREFULLY

The information on this form is required under the New York State Comptroller's Rules and Regulations ( 2 NYCRR 102 ).  The information is confidential and is needed to process payment data from the State to the financial institution and/or its agent.  Failure to provide the requested information may delay or prevent the receipt of payments through the Direct Deposit/Electronic Funds Transfer Program. 

MULTIPLE DIRECT DEPOSIT 

Employees may choose up to seven fixed amount or percent direct deposits, as well as one net pay or excess pay direct deposit after all fixed amount or percent direct deposits. 

CANCELLATIONS 

The agreement represented by this authorization remains in effect until cancelled by the employee or  the financial institution.  To cancel, the employee must complete and Enrollment/Change Form that contains all account data information as required in Section 1 or 2 for the transaction to be cancelled. 

The agreement represented by this authorization may be cancelled by the financial institution by providing the employee and the State agency with a written notice 30 days in advance of the cancellation data.  The financial institution cannot cancel the authorization without notification to both the employee and the State agency.

CHANGES

Employees may add or delete a direct deposit by completing a new Direct Deposit of Salary Enrollment/Change Form.  New fixed amount or percent direct deposits will be assigned a lesser priority than existing fixed amount or percent direct deposits.  For example, if an employee's  pay is not sufficient to cover all direct deposits, the most recently designated direct deposit(s) will not be taken. To change direct deposit priorities, please contact your agency payroll officer. 

Financial institution changes may take up to two payroll periods.  Employees should maintain accounts deleted and replaced by new accounts until the transaction is complete, i.e. until the new financial institution receives the employee's direct deposit transaction.  If  accounts at deleted financial institutions are not maintained, employees may experience a delay in payments until new authorizations  take effect.