Huntsville FireFighters Association, L1833

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FireFighter Cancer Foundation
The Fire Fighter Cancer Foundation promotes knowledge, awareness, and advocacy for the Fire Fighter diagnosed with cancer.

The IAFF Center of Excellence for Behavioral Health Treatment and Recovery is a one-of-a-kind addiction treatment facility specializing in PTSD for IAFF members – and IAFF members only – who are struggling with addiction, PTSD other related behavioral health challenges to receive the help they need in taking the first steps toward recovery. It is a safe haven for members to talk with other members who have faced or overcome similar challenges.

AUTHORIZATION FOR AUTOMATIC PAYROLL DEPOSITS

I, , hereby authorize and instruct THE CITY OF HUNTSVIUE- FINANCE DEPARTMENT- PAYROLL DIVISION to deposit the amount of each of my payroll payments directly into my checking and/or savings account indicated below in the DEPOSIT INSTRUCTIONS and to make any such withdrawals directly from my account (s) as are necessary to correct any incorrect deposit by The City of Huntsville under this Authorization.

I further hereby authorize and instruct the financial institution named below (the "institution") to accept such automatic deposits to or withdrawals from my account(s) by The City of Huntsville and to cause my account(s) to be automatically credited or debited (as the case may be) in the amount of such deposits or withdrawals by The City of Huntsville without any responsibility for the correctness of any such deposit or withdrawal.

DEPOSIT INSTRUCTIONS

♦ EMPLOYEES MAY CHOOSE UP TO TWO DIRECT DEPOSITS.
♦ EMPLOYEES MAY HAVE ONLY ONE DEPOSIT PER FINANCIAL
INSTITUTUION.

Please deposit the full amount of each of my payroll payments to my CHECKING account (must attach voided check)
Please deposit the full amount of each of my payroll payments to my SAVINGS account (must attach bank form that includes bank routing number and account number)
Please deposit from each of my payroll payments to ONE of the following: CHECKING account (must attach voided check) SAVINGS account (must attach bank form that includes bank routing number and account number)
Please STOP the full amount of each of my payroll payments going to my account.
I understand that I can cancel this authorization at any time. To cancel, I must give written notice to both The City of Huntsville and the "Institution". My cancellation will become effective when The City of Huntsville receives my notice of cancellation and has had a reasonable period of time upon which to act on it. Any automatic deposits to or withdrawals from my account(s) by The City of Huntsville up until that time will be authorized by this authorization. My cancellation of the authorization will become effective when the "institution· receives my notice of cancellation and has had a reasonable period of time upon which to act on it. Any automatic credits or debits made to my account(s) by the "institution" up until that time will be authorized by this authorization. I further understand that all automatic deposits and credit to or withdrawals and debits from my account(s) under this authorization will be subject to all rules, regulations, agreements and disclosure statement of The City of Huntsville and the "institution"·governing accounts and preauthorized transfers to and from accounts.
Employee ID #		Department #
Signature: Use your mouse, finger, or touch device to write your signature.		Date

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