SOP 104.36-att-1: SAO Direct Deposit Notification Form

SOP 104.36
Attachment 1

1/30/18

Direct Deposit Notification Form
(To be signed by all new hires and rehires on and after May 1, 2010)

In accordance with the Mandatory Direct Deposit policy issued May 1, 2010, as a condition of
employment, a person hired or rehired to a position in a State organization on or after May 1, 2010, and
paid by the PeopleSoft HCM central payroll system (system) administered by the State Accounting
Office (SAO), is required to accept all payroll related payments by direct deposit. The complete policy,
and related documents, can be found on SAO’s website at the following location: [State Accounting](http://sao.georgia.gov/00/channel_createdate/0,2095,39779022_141768085,00.html)
[Office Accounting Policy Manual.](http://sao.georgia.gov/00/channel_createdate/0,2095,39779022_141768085,00.html)

I understand that as a condition of employment, because I am a new hire or rehire applicant, I must comply with
the policy and enroll in direct deposit using the Employee Self Service (ESS) feature of the system within 30 days
of being hired or rehired and remain enrolled in direct deposit during the tenure of my employment. I understand
that I can apply for an exemption from this requirement as provided by the policy. I understand that if I am not
granted an exemption, I may be subject to dismissal.

Employee Name (Please Print) _______________________________________________________

Employee Signature: ______________________________________________ Date: ____________

To Be Completed By Employing Organization:

Employee ID Number: ___________________ Position Title: ______________________________

Hiring Organization Name: __________________________________________________________

Hiring Supervisor or HR Official: _____________________________________________________

Retention Schedule: Upon completion, the original shall be retained permanently in the employee’s Human
Resources file and a copy shall be given to employee.