The Early Childhood Commission

Title: Early Childhood Practitioner Direct Deposit Authorization Form

Document Number: ECC/FIN/ECPDD/F001 Issue Date: 18/04/2018 Last Revised: 18/04/2018
Approved By: Director, Finance Revision Number: 01 Page: 1 of 2

Salary Subsidy Practitioner Banking Information Form for Transfer of Salary Payment
Please complete this form using BLOCK LETTERS ONLY

I ____________________________________________________________________________________
FIRST NAME MIDDLE NAME (S) SURNAME

TRN: _____________________________________ Employee ID Number: _________________________

hereby gives Early Childhood Commission (ECC) permission to lodge my salary subsidy payment to my personal account

as noted below;

School/ECI: ___________________________________________________________________________

School Address: _______________________________________________________________________

Contact Number (s): ____________________________________________________________________

Email Address: ________________________________________________________________________

Region: ________________________________ Zone: __________________________________

Account Number: ______________________________________________________________________

Type of Account (i.e. Chequing or Savings): _________________________________________________

Name of Banking Institution: ____________________________________________________________

Bank Address/Branch Name: _____________________________________________________________

 The Early Childhood Commission
Title: Early Childhood Practitioner Direct Deposit Authorization Form
Document Number: ECC/FIN/ECPDD/F001 Issue Date: 18/04/2018 Last Revised: 18/04/2018
Approved By: Director, Finance Revision Number: 01 Page: 2 of 2

Please note that only Commercial Bank accounts are acceptable. The account must be in the name of the Early
Childhood Practitioner. Proof of bank account information such as a bank statement must accompany this form.

Signature: ___________________________________ Date: _________________________________