Direct Deposit Authorization Form

Student ID*

Please input the last 4 digits only.

Email*

Are you submitting to change existing account information on file?*

Yes
No

I, ______________, hereby authorize Atlanta’s John Marshall Law School (AJMLS) to initiate credit entries for sums to and payable to me from excess financial aid to my checking, savings or other account indicated below and the Financial Institution named below. I also authorize AJMLS to initiate debits for sums due to the Law School for erroneous deposit or deposits at my Financial Institution.

PRINT NAME BELOW

Name to insert in above statement*

PLEASE NOTE

You must attach documentation of your routing and account number. This form cannot be processed without this.

Documentation of your routing and account number. You can use a letter from your banking institution OR a voided check. Failure to attach documentation will delay receipt of refund.*

Drop files here or

Max. file size: 20 MB.

Bank Name*

Bank Transit ABA Number*

Please Confirm: Bank Transit ABA Number*

Bank Account Number*

Please Confirm: Bank Account Number*

Type of Account*

Checking
Savings
Money Market

Signature

This authorization is to remain in full force and effect until AJMLS has received written notification from me of its termination or until I am no longer a student at AJMLS.

Student Signature*

Please type your name as your electronic signature.

Date*

PLEASE NOTE

Signature

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