Direct Deposit Payee's Authorization Form Baltimore County Office of Budget and Finance and Baltimore County Public Library
Please fill out the form on your screen, print out and mail to the address listed below. The Credit Union requires an INK Signature for this application. We will not accept a faxed copy. This helps to reduce account fraud.
I authorize the Baltimore County Office of Budget and Finance or Baltimore County Public Library and the financial
institution listed below to deposit my net pay automatically to my checking or savings account each payday.
In the event that funds are deposited to my account that I am not entitled to, the Baltimore County Office of Budget and
Finance or Baltimore County Public Library is authorized to notify the financial institution to debit my account to return
ITEMS (1) THROUGH (6) MUST BE COMPLETED TO PROCESS THIS REQUEST.
Social Security #
I am employed by Baltimore Co. Government - Department:
I am employed by Baltimore Co. Public Library - Branch Location:
Baltimore County Employees Federal Credit Union - Account Number:
Pending account verification, this transaction will be effective the second payday after receipt.
*ANY CHANGE IN ACCOUNT NUMBER OR FINANCIAL INSTITUTION WILL CAUSE A BREAK IN
DIRECT DEPOSIT. A CHECK WILL BE CUT FOR YOU THE DAY AFTER THE ACCOUNT CHANGE.
This authorization agreement is to remain in full force and effect until written notification is received from the payee, in
such a manner as to afford the payor a reasonable opportunity to act on it. For more information, call Baltimore County
Pay System Division at (410) 887-2420 or Baltimore County Public Library Accounting Office at (410) 887-6173