The University of Memphis
Direct Deposit Authorization Form
Bursar's Office
115 Wilder Tower
Memphis, TN 38152-3520
(Automatic Deposit Of Excess Student Financial Aid or Other Bursar Student Account Refunds )
Click here for online help.
  • Complete all requested information on the form.
  • Sign and date your authorization.
  • ATTACH A VOIDED CHECK (for checking account only, and return to the Bursar's Office (address listed above).
Note:   This data remains on file in the Bursar's Office from semester to semester. If your bank account information changes, you must complete a new form. You will be responsible for any bank fees/charges resulting from your failure to update your bank account information with the Bursar's Office.
NEW Request CHANGE of account information CANCELLATION of a prior request
Student Name: Student ID Number: - -
Home Phone: - Work Phone: -
Student Address:
Name of Bank or Credit Union (Branch, if any):
Address of Bank or Credit Union:
Checking Account Number: * Savings Account Number:
Bank or Credit Union Routing Number:
(This number appears between these symbols |:|: on the bottom left of your check.)
* Note: If savings account is indicated, please verify account and routing number with bank before submitting form.

I hereby authorize:

  1. The University of Memphis to deposit my refund via electronic funds transfer.
  2. My financial institution to credit this amount to my account.
  3. The University of Memphis to deduct from my excess student financial aid award proceeds (amounts in excess of my assessed enrollment and housing fees for the current semester) any other amounts I currently owe The University of Memphis.

In the event that the exercise of this authorization for any reason results in an overpayment of financial aid actually due and payable to me, I hereby authorize the University to either: (a) withhold a sum equal to the overpayment from my next disbursement of financial aid, or (b), debit my above-identified checking or savings account for an amount not to exceed said overpayment. I understand that I may be subject to financial aid billing which I must repay to The University of Memphis if I withdraw or do not enroll in a subsequent term and have received financial aid via EFT which is in excess of my financial aid eligibility, or if an over award occurs. If any action taken by me, without adequate notification to the Bursar's Office, results in non-acceptance of the transfer by my financial institution, I understand that the University assumes no responsibility for processing supplemental financial aid until funds are returned to the University by my financial institution.

Signature _________________________________  Date _____________________

The University of Memphis, one of the Tennessee Board of Regents institutions, is an Equal Opportunity/Affirmative Action University.