PRINT NAME:
TWU ID #:
DEPARTMENT:
PHONE NO:
DIRECT DEPOSIT
DECLINATION STATEMENT
I understand that the Texas Woman’s University requires all employees to have their wage payments
made through electronic funds transfer (direct deposit). However, I must decline for the following
reason:
It would be impractical for me to receive the payment by electronic funds
transfer.
It would be more costly to me to receive my wage payment by electronic
funds transfer than by receiving my payment by check.
I am unable to establish a qualifying account at a financial institution to
receive electronic funds transfers.
If you are declining direct deposit, your check will be
mailed to the address you list below:
SIGNATURE:___________________________________
DATE:
NOTE: THERE IS A $5.00 CHARGE TO REPLACE A CHECK FOR ANY REASON.
TEMPORARY
DECLINATION STATEMENT
I understand that the Texas Woman’s University requires all employees to have their wage payments
made through electronic funds transfer (direct deposit). However, I currently do not have a qualifying
account at a financial institution. I will make arrangements to open a qualifying account and then
process a direct deposit authorization agreement within 60 days of my employment date.
Signature:
Date: