Direct Deposit Enrollment Request for State Employees

State employee requests direct deposit enrollment, changes or cancellations.

Two Options for Submitting Direct Deposit Requests

Option 1: Download, print, scan and mail to Human Resources

Option 2: Download, print, scan and upload to a secure UBBox folder

A Copy of Your UB Card is Required

As an added measure of security, we require that you submit a copy of your official UB Card with your direct deposit request form. 

Choose a Submission Option

Instructions

  1. Read through all pages of the document to find specific instructions, if any
  2. Enter requested information into the form
  3. Print the form
  4. Get required signatures
  5. Scan a copy of the signed form for your records
  6. Send the original, completed, signed form and a copy of your UB Card to:         

Human Resources
University at Buffalo
Townsend Hall
205 Hayes Road
Buffalo, NY 14214

Include a Voided Check or Written Verification

A voided check or written verification from the financial institution showing the account number, routing number, and name(s) on the account must accompany this form for each account listed (SECTION B and C)

STOP

Don't Forget!

  • A copy of your official UB Card
  • A voided check or written bank verification

Failure to include these items will create a delay in processing. 

Instructions

1. Read through all pages of the document to find specific instructions, if any

2. Enter requested information into the form

3. Print the form

4. Get required signatures

5. Scan a copy of the signed form to your computer device

  • Save your documentation as a single PDF file
  • Name your file: Your Last Name_Your First Name_Your Person Number
  • Example:  Doe_John_55552222

Files not saved in this manner will be rejected.

6. Drag and drop your completed, signed, single PDF file to the file upload widget

Include a Voided Check or Written Verification

A voided check or written verification from the financial institution showing the account number, routing number, and name(s) on the account must accompany this form for each account listed (SECTION B and C)

STOP

Don't Forget!

  • A copy of your official UB Card
  • A voided check or written bank verification

Failure to include these items will create a delay in processing. 

Need Help Completing the Form?

Form Facts

Form Type: Downloadable, PDF document

Requirements: Adobe Reader

Updated: Option to uploaded added April 2020

Owner: Human Resources