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Fill out the required information on the Authorization Form and send in the form along with a current voided check (for applicants with checking accounts). Mail all form to: UCLA Administrative Main Cashier Office Box 951432, 1125 Murphy Hall 405 Hilgard Ave Los Angeles, CA 90095-9000 To void a check, simply write the word "VOID" across a blank check. This ensures that nobody can use the check, but still allows SFS staff to verify your account information. The image below shows how to locate your account number and routing number.



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I hereby authorize the University of California Los Angeles to deposit my refund via electronic funds transfer to my financial institution to credit this amount to my account. This authorization remains in effect until cancelled. A new authorization must be completed if I change or close my account, or change financial institutions. I also authorize the University to initiate a debit transaction to my account, but only as an appropriate adjustment to a credit for the same payment. Please complete the authorization form and return to Administrative Main Cashier Office, Box 951432, 1125 Murphy Hall, 405 Hilgard Ave Los Angeles, CA 90095-9000.

Name: ____________________________________________________________________UID____________________________ Account Number: ______________________________________ Routing Number: ____________________________________ Bank Name & Address: _____________________________________________________________________________________ Checking: Savings: Do you intend to transfer the funds deposited to your account to a bank outside the US jurisdiction? Yes: No: If you answer "yes" to this question, you do not qualify for this process and all refunds must be issued in the form of a check due to federal regulations. Your check will be sent to the mailing address listed on BAR. Signature: _______________________________________________________________ Date: ___________________________


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