UNIVERSITY OF GUAM			Administration and Finance
	
Unibetsedåt Guahan		Payroll Office

CANCELLATION OF DIRECT DEPOSIT ( Form PAYR-05 )

Employee Name		
ID #		
Contact Number 		
Department / Unit		
Financial Institution		
Branch		
Account #		
Effective date:		

I hereby authorize the University of Guam, Payroll Office to CANCEL the direct deposit of my net payroll check.

			
Signature of Employee		Date