Federal Work Study

Payroll Deduction Request/Change Form

I request a payroll deduction of my bi-weekly paycheck to be paid directly to my student account. This deduction will begin with the next available pay period and end with the last payroll of the academic year. I understand that this amount will be taken out of my payckeck and paid to my student account regardless of the balance on my student account. I understand that it is my option to cancel this request at any time and will do so in writing or by submission of this form.
Student Name__________________________________________________________________
Hope ID/Account #(s)_______________________________________________________________________
Circle One
New Deduction
FWS deduction amount (per paycheck) $_________
Signature___________________________________ Date_____________________________-



Return this form to Payroll, Office of Human Resources. Thank you.