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California State University, Long BeachCalifornia State University, Long Beach

Employee Reimbursement Direct Deposit Authorization

General Instructions

  1. Review the Detailed Instructions for Employee Reimbursement Direct Deposit Authorization
  2. Enrollment in Direct Deposit for reimbursements is separate and apart from enrollment in direct deposit for your wages. Payroll is processed with either the State Controller's Office in Sacramento or the Foundation payroll office. Changes made to enrollment in Direct Deposit for payroll do not carry over to your reimbursements. You must maintain your enrollment information with each area.
  3. Indicate if you are enrolling for the first time, updating your enrollment for a banking change, or cancelling your enrollment.
  4. Indicate your payee information: Employee/Student ID number, Name, Address, Contact Information. The EMPLID number is a 9-digit number assigned to all employees. All numerals are required including leading zeros. Complete the name field with your full legal name. Provide your campus contact information email and phone extension. Email notifications of payment will be sent by the financial system.
  5. Attach any supporting documentation to this Direct Deposit Form and submit to Accounts Payable.
    1. LBCMP - University Controller's Office - Accounts Payable, Foundation Building Suite 280 (MS-9901), 6300 State University Drive, Long Beach CA 90815-4680 phone (562)985-2512.
    2. LBFDN - Accounts Payable Foundation, Foundation Building, Suite 332, 6300 State University Drive, Long Beach CA 90815-4680 phone (562)985-5537.
  6. Complete the form and use the button below to display a printer friendly version.
Fields with * are required.

*Employee/Student Information Employee:

Student:
ACH Activity Type (mm/dd/yy)

*Please check one indicating ACH activity type

Note:Please allow up to 10 business days for ACH setup
Payee Contact Information




Financial Institution & Account Information - attaching a copy of a voided check is recommended but not required *Direct Deposit to:





(nnn-nnn-nnnn)

STATEMENT OF PAYEE'S RESPONSIBILITIES

I hereby authorize CSU Long Beach to initiate direct payment to the account & financial institution listed above for the payment of any reimbursement due to me.If at any time the amount deposited exceeds the amount due and payable to me, I hereby authorize the Accounts Payable department to recover such overpayment from the above designated account.

Additionally, I acknowledge, understand and agree to abide by the following rules & guidelines:

  1. It is my responsibility to provide accurate & current banking information to CSU Long Beach for direct deposit requests.
  2. Email notification of payment will be sent to me by CSU Long Beach and it is my responsibility to verify payment has been credited to my account.
  3. I understand that CSU Long Beach and the Foundation will assume zero overdraft liabilities and may retrieve overpayment provided this activity occurs not less than five (5) business days after notification of such overpayment is sent to me.

This Authorization will remain in effect until cancelled in writing. A new authorization form will be completed if I change my bank account, close my bank account or change financial institutions.

Payee/Requester Signature Date

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Employee Reimbursement Direct Deposit Authorization Instructions

Completion Instructions
Enrollment in Direct Deposit for reimbursements is separate and apart from enrollment in direct deposit for your wages. Payroll is processed with either the State Controller's Office in Sacramento or the Foundation payroll office. Changes made to enrollment in Direct Deposit for payroll do not carry over to your reimbursements. You must maintain your enrollment information with each area.
Indicate if you are enrolling for the first time, updating your enrollment for a banking change, or cancelling your enrollment.
Indicate your payee information: Employee/Student ID number, Name, Address, Contact Information. The EMPLID number is a 9-digit number assigned to all employees. All numerals are required including leading zeros. Complete the name field with your full legal name. Provide your campus contact information email and phone extension. Email notifications of payment will be sent by the financial system.

Check New for first time setup of Enrollment Payments or Update for Change in Financial Institution and/or Account Information or Termination for Cancel Enrollment Payments.

Fill out payee information: Vendor Name, Address, Tax ID, and Contact information. Complete the name field with full legal name. Provide the contact information email and phone number.

Employee/Student Information Box 3.

Enter your Financial Institution Information. Indicate checking OR savings. Only one box must be checked. If left blank it will be processed as checking. Enter the Routing Number and your account number. See the Helpful Tips for information on Banking and Routing numbers.
Indicate Direct Deposit to Checking or Savings/Money Mkt account. Bank Routing # is the 1st 9 digits at bottom of a bank check.Bank Account # is the following 14 digits after the Bank Routing # (See images below). Indicate Financial Institution name, street address, city, state, and zip code. Phone number is not required.
Sign and date your form. Completed forms should be sent to the appropriate Accounts Payable department for processing
Statement of Payee's Responsibilities
I hereby authorize CSU Long Beach to initiate direct payment to the account & financial institution listed above for the payment of any reimbursement due to me. If at any time the amount deposited exceeds the amount due and payable to me, I hereby authorize the Accounts Payable department to recover such overpayment from the above designated account.
Additionally, I acknowledge, understand and agree to abide by the following rules and guidelines:
  1. It is my responsibility to provide accurate & current banking information to CSU Long Beach for direct deposit requests.
  2. Email notification of payment will be sent to me by CSU Long Beach and it is my responsibility to verify payment has been credited to my account.
  3. I understand that CSU Long Beach and the Foundation will assume zero overdraft liabilities and may retrieve overpayment provided this activity occurs not less than five (5) business days after notification of such overpayment is sent to me.
This Authorization will remain in effect until cancelled in writing. A new authorization form will be completed if I change my bank account, close my bank account or change financial institutions.
Payee Requestor Name fields: Box 1: Print Name. Box 2: Signature. Box 3: Date.
Attach any supporting documentation to this Direct Deposit Form and submit to Accounts Payable: Ver 9-20-12
  • LBCMP - University Controller's Office - Accounts Payable, Foundation Building Suite 280 (MS-9901), 6300 State University Drive, Long Beach CA 90815-4680 phone (562)985-2512
  • LBFDN - Accounts Payable Foundation, Foundation Building, Suite 332, 6300 State University Drive, Long Beach CA 90815-4680 phone (562)985-5537
Employee Reimbursement Direct Deposit Posting dates
While most financial institutions post funds to accounts at the beginning of the bank business day, this is not a universal practice. Some Institutions post funds to accounts in the afternoon instead of the morning. It is strongly recommended that you check with your financial institution to determine when your funds will be available.
Changing Financial Institution or Bank Accounts
Your reimbursements will continue to deposited into your designated account at your financial institution until the appropriate Accounts Payable Office is notified that you wish to change your bank account number/or your financial institution. To change, complete and submit a new enrollment form. IF YOU HAVE REIMBURSEMENTS PENDING, DO NOT CLOSE YOUR OLD ACCOUNT UNTIL YOU HAVE NOTIFIED US OF YOUR CHANGE.
Privacy Notice
The information Practices Act of 1977 (Civil code Section 1798.17) and the Federal Privacy Act (Public Law 93-579) require that this notice be provided when collecting personal information from individuals. Information requested on this form will be used by the California State University, Long Beach for the purposes of identification and enrollment processing. It is mandatory to furnish all information requested on this form except for the phone number of the financial institution.
Helpful Tips

Where are my Bank Routing and Bank Account Numbers?


The line of numbers and special symbols at the bottom of one of your personal checks or deposit slips contains the bank routing and bank account number information you need to enter on the form.

Example 1: Sample Check

Bank Routing # is the 1st 9 digits at bottom of a bank check. Bank Account # is the following 14 digits after the Bank Routing #. Check # is the last 4 digits after the Bank Account #.

Example 2: Sample Deposit Slip

Bank Routing # is the 1st 9 digits at bottom of a bank check.Bank Account # is the following 14 digits after the Bank Routing #.

Bank Routing Numbers
Your bank routing number is the nine digit number which usually appears to the left of your bank account number on the bottom of your check.
Bank Account Numbers
Your bank account number usually appears to the right of the bank routing number. It can be up to 17 characters long and contains only digits and possibly hyphens. If the bank account number printed on your check contains spaces, you do not need to enter the spaces.

Note: Some banks display the check number to the left of the bank account number. Be sure you don't include the check number as part of the bank account number.

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