Form Name:
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Used for:
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Establishing direct deposit of an employee's net pay to one or two financial institutions anywhere in the United States. Institution must be a member of the ACH(Automated Clearing House).
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Available to all Brown University employees.
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Net pay may be split among two accounts in two different financial institutions (four distributions in total).
Required Fields:
| Bank Name & Location [1]: | Full name of the first (or only) bank or financial institution, the city, state and zip code. |
| Bank Transit No.: | Enter complete number-found on the bottom left corner of check or deposit ticket. |
| Checking Acct No. & Percent: | Enter complete checking account number and the percent of your net pay to be deposited |
| Savings Acct No. & Percent: | Enter complete savings account number and the percent of your net pay to be deposited.. |
| Bank Name & Location [2]: | Enter
name and location of the second bank or financial institution,
if any, and information as above. |
| Name & Signature: | Print full name, sign and date. |
Documents to Attach:
Must attach a voided check and/or savings deposit slip for each account included in the distribution.
Where to Send:
Mail or bring to the Payroll Office, Box 1873, second floor of the Brown Office Building.
How to Obtain:
Forms are available in the Payroll Office. Employees can pick up at the window or call and have mailed to their departmental address.
Special Notes:
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You must notify Payroll immediately if changes are made in accounts. Failure to do so may affect the timing of your pay.
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All new direct deposits or changes made must go through a "pre-note" process. This process is basically a "dry-run", made to detect any errors which may occur during actual processing.