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UNIVERSITY OF CALIFORNIA, SANTA BARBARA
GAUCHO DIRECT DEPOSIT
Authorization Form
(Questions? Go to http://www.barc.ucsb.edu/Billing/refunds.htm )
New
Change
I hereby authorize the University of California, Santa Barbara to (1) deposit my refund check via electronic
transfer of funds, and (2) my financial institution to credit funds to my checking account. This authorization
will remain in effect until cancelled in writing.
Name: PERM #:
Phone No.: Email Address:
Signature:
Date:
Account Number:
Routing/Transit Number:
Bank Name:
Branch Address:
Branch City: State: ZIP:
* * * ATTACH VOIDED CHECK HERE * * *
Mail or deliver this completed form to:
BARC Systems & Operations
University of California Santa Barbara
1212 SAASB
Santa Barbara, CA 93106-2003
http://www.barc.ucsb.edu/
(805) 893-3756
FAX (805) 893-8063