Authorization For Direct Deposit Of Vendor Payments (ACH)
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|Instructions: Please complete the requested
information throughout the form, sign and date your authorization, ATTACH A VOIDED CHECK, and
The University of Memphis
275 Administration Bldg
Memphis, TN 38152-3370
This Authorization Is For:
I hereby authorize:
In the event that the exercise of this authorization for any reason results in an overpayment for vendor invoices actually due and payable to me, I hereby authorize the University to either: A) debit my above-identified checking account for an amount not to exceed said overpayment, or B) withhold a sum equal to the overpayment from my next disbursement of vendor invoice payment.
I understand this authorization applies only to my vendor record and does not effect my payroll direct deposit information.Signature: __________________________________________________ Date: __________