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Payroll Direct Deposit Form

  1. Type of Account
    Select one.
  2. Please enter the email address where you would like to have your direct deposit advice sent. You will no longer receive paper advices.
  3. I authorize the City of Norwich to implement the payroll direct deposit information I have provided on this form. This authorization will remain in effect until the City of Finance Department has received written notification from me of its termination, in such time and in such manner to afford the City of Norwich and the Financial Institution named above a reasonable opportunity to act on it.
  4. Employee Signature
  5. Date
  6. Leave This Blank: