EMPLOYEE PAY SELECTION
You have multiple options to receive your pay. In keeping with the University’s move to ‘green’ choices, the Payroll Office
would like to eliminate the use of paper checks. The two pay options listed below are the University’s preferred methods for
paying employees which provides a dependable, safe, and convenient way to accessing pay. Please review them and make
your selection by initialing your choice and signing below. Signature is required regardless of pay option selected.
DIRECT DEPOSIT
INITIAL
I select direct deposit for disbursement of my pay.
I hereby authorize my employer (“American University”) to initiate deposits of my net pay into
the account at the financial institution submitted by me electronically and further authorize
my Financial Institution to credit the account indicated with the deposits. This authority
is to remain in effect until American University or my Financial Institution has received
notification from me of termination of such authorization in such time and such manner as to
afford American University and Financial Institution a reasonable opportunity to act on those
instructions or until American University or Financial Institution cancels the direct deposit
arrangement. Below are the ways you can sign up for Direct Deposit:
- Electronic (requires sign up through HR/Payroll Connection.
(Path: Payroll > General > Add Direct Deposit. Follow all on-screen instructions.)
- Paper (requires voided check and Direct Deposit Application Form)
MONEY NETWORK™ SERVICE
I select Money Network™ and TotalPay® Card for disbursement of my pay.
INITIAL
I hereby authorize my employer (“American University”) to initiate deposits of my net pay into
the account assigned to me and further authorize the Financial Institution to credit the account
indicated with the deposits. The Money Network™ Check is a paycheck I can easily complete
on or after each payday morning, wherever I am, eliminating the need to pick up my paycheck,
wait for it to be mailed, or pay for it to be cashed. The Check can be deposited into my personal
bank account or cashed for free at Money Network check-cashing partners. There is no fee for
using Money Network Checks. I am automatically eligible for the Money Network TotalPay®
Card and there is no application or approval process. There is no monthly service charge for an
active TotalPay® Card as long as I am employed by American University. Many TotalPay® Card
transactions are free, but there are fees for other transactions. All of the transaction fees are
listed in the Welcome Kit.
I authorize American University to disburse my pay according to the selection I initialized above. I understand that I can change
my pay selection at any time in the future. If funds to which I am not entitled are deposited to my account, I authorize debits
from my account and the return of such funds. This completed form must be returned to the Payroll Office as soon as possible.
If neither of the above payment methods is acceptable to me, I understand that I should contact the Payroll Office
to discuss other options.
SIGNATURE
DATE
REQUIRED
PRINTED NAME
REQUIRED
AU ID
Office of Human Resources
3201 New Mexico Ave NW, Suite 350
202.885.2591 Fax: 202.885.2558
www.american.edu/hr
DIRECT DEPOSIT APPLICATION
STEP 1: Complete this section.
Name
AU ID
Social Security #
Department
Email Address
Work Phone
Home Phone
I work
Full Time
I am a
Monthly
I am paid
Part Time
Action
Student
New Direct Deposit
Delete previous accounts and
change to the accounts below
Faculty
Bi-weekly
Staff Member
Stop Direct Deposit
STEP 2: Complete this section. Contact your financial institution for bank transit/ABA number.
BANK ACCOUNT #1
BANK ACCOUNT #2
If you wish to have direct deposit for more than two accounts,
please complete another copy of this form and attach it.
Bank Name
Bank Name
Bank Transit/
ABA Number
BANK ROUTING/
TRANSIT NUMBER
Bank Account
Number
Account Type
Bank Account
Number
Amount to be transferred
Checking
Total Net Pay
Savings
Partial Amount: $_____________
Bank Transit/
ABA Number
Account Type
NOTE: Remainder must be direct
deposited into another account.
Amount to be transferred
Checking
BANK ACCOUNT
NUMBER
Balance of pay amount
Savings
STEP 3:
For direct deposit to checking attach:
- A voided check OR
- Checking account issue card OR
- Direct Deposit Form from your financial institution.
For direct deposit to savings/investment account attach:
- Savings account issue card OR
- Direct Deposit Form from your financial institution.
STEP 4: Carefully read these terms of agreement for direct deposit:
If I want to cancel direct deposit... I understand that I may cancel my Direct Deposit by providing written notice to Human
Resources at least TEN (10) BUSINESS DAYS before the next payroll due date.
If I change or close my Bank Account... I understand that it is solely my responsibility to notify Human Resources immediately
of any changes to my bank account that might affect my direct deposit.
If I separate from the university... I understand that my final payment will be a check.
CONFIRMATION OF DEPOSIT
I understand it is my responsibility to prevent overdraft by verifying each deposit is in my account before I write checks. In the event
that funds are transmitted in error to my account, I authorize American University to reverse the deposit of such funds from my
account. I understand that if a reversal of funds is necessary, I will be advised by the university in advance.
STEP 5: Sign
I certify that the information provided is correct and that I have read and understood the terms of this agreement. By signing
this agreement, I authorize AU to send my payments to the account(s) at the financial institution(s) named above.
SIGNATURE
FOR HR USE ONLY:
BANK CODE #1: INITIAL:
DATE ENTERED: DATE
BANK CODE #2: Office of Human Resources
3201 New Mexico Ave NW, Suite 350
202.885.2591 Fax: 202.885.2558
www.american.edu/hr