BSC MTA Direct Deposit Form – Fill Out and Use This PDF

Direct Deposit Authorization Form

HR-HRIS-024

Section 1 - Information and Instructions

The purpose of this form is to authorize the deposit of your net pay automatically into a maximum of six (6) accounts(s) in the bank(s) of your choice. A direct deposit can be made to any commercial or savings bank in the Greater New York Metropolitan area that is a member of the ACH (Automated Clearing House) System (check with your bank before enrolling). Direct deposit can also be made to a credit union account.

Please email a signed copy of the form to bscservice@mtabsc.org or fax to 212-852-8700 .

If you have any questions, please contact the Business Service Center (BSC) at 646-376-0123 or bscservice@mtabsc.org.

Section 2 - Employee Information

Section 3 – Transaction Type

I authorize the Metropolitan Transportation Authority and the financial institution(s) listed below to:

*If changing or making updates to Direct Deposit accounts, you must re-list all accounts in priority order, even if some are not changing. All Credit Union accounts are given first priority unless noted otherwise.

Section 4 - Bank/Credit Union Account Information (only complete if enrolling or changing Direct Deposit)

Please fill out the bank/credit union account information completely if enrolling in or changing Direct Deposit. If depositing to more than one account, use page 2 to fill out the information for additional accounts, listed in priority order, and ensure that one of the bank accounts provided has the option checked for “deposit balance of net pay to this account.” Only 6 accounts permissible.

Note: It takes approximately 1 to 2 pay periods to process a change to an existing direct deposit account. During this period, depending upon your direct deposit structure and the account you’re changing, you should expect either a paper check or the funds deposited into the

account checked below as “Deposit balance of net pay to this account.” Employees are advised to make adequate arrangements to prevent account overdrafts as the process takes effect.

Business Service Center

Direct Deposit Authorization Form

HR-HRIS-024

Section 5 - Additional Bank Account Information (maximum of 6 accounts permissible)

BANK ACCOUNT/CREDIT UNION 2

BANK ACCOUNT/CREDIT UNION 6

Section 6 - Authorization

I wish to enroll in/change/cancel my enrollment in the Direct Deposit Payroll Program, as indicated above. I agree to notify my employer immediately of any changes to the information so that my pay may be properly distributed. I understand that in the event my employer notifies my financial institution that I am not entitled to the funds deposited to my account, my bank is authorized to debit my account for the amount of the adjustment. I understand that in the event my financial institution is not able to deposit any electronic transfer into my account due to any action I take, my employer cannot issue the funds to me until the funds are returned to my employer by my financial institution.

Attention LIRR union employees with mandatory direct deposit: If you wish to stop direct deposit, please contact your agency HR representative for approval.

LIRR Approver Signature:

Business Service Center