NC State University
Direct Deposit Consent

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New Enrollment

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Change Enrollment

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Delete Enrollment

Student's Name

Last
 
First
 
M
 

Student ID


000__ __ __ __ __ __ 

Bank Name

 

Bank ABA Number

Checking Account Number

Student's Local Phone Number
(          )            -              
 

 

Attach here a preprinted check across which you have written "VOID". The preprinted information must include the financial institution's bank number and the student's checking account number.

 

Instructions:

Complete all information blocks with the required information. The checking account number is 0 to 17 digits and can be found in the middle section of your check. Write this number from left to right in the block provided. The checking account number will begin with two digits from 12 to 25. The bank's ABA number is 9 digits and appears in the lower left-hand corner of your check.

Attach a preprinted check across which you have written "VOID".

Please read the following carefully:

Once your consent for direct deposit has been processed, a one-time zero ($0.00) dollar transaction will process and may appear on your bank statement. This transaction is a test to ensure the accuracy of the electronic deposit transaction. Your signature on this consent form authorizes the university to apply financial aid monies to the balance of your student account including charges left unpaid in a previous semester. Proceeds from any financial aid award will be deposited within two (2) business days of receipt by the university. If funds are elctronically deposited to your checking account in error, the university can initiate a debit transaction against the account to recoup the funds.

The information provided on this form will continue to be in effect for subsequent semester financial aid awards unless the student submits a consent form to change enrollment.

Signature
 
Date