UNICEF Authorization for Direct Deposit of MPO Form UNICEF (12/11)

UNICEF Authorization for Direct Deposit����  Of Monthly Payment Order

Submit to: (Human Resources Officer responsible for your duty station in DHR)

Personal Information

Index No.: First Name: Division/Section: Middle Name: Duty Station: Last Name: Room: E-Mail: Phone:

Bank Information Internationally recruited field staff will be paid the specified monthly portion at the locally designated bank account. The Finance Section at the duty station will specify the payroll payment currency. Currency of Payment: Currency of Bank Account: Bank Name: Bank Country: Account Number: Account Type: Bank Address: Bank ID Number Length varies by country. If required, Finance Section at duty station will verify length. BIC/Swift Address - 11 digits For bank accounts in IBAN Format, the BIC/SWIFT address must be the one related to the IBAN. IBAN Account Format Length varies by country. If required, Finance Section at duty station will verify length.

What portion of your salary do you wish to receive locally at the duty station in payroll currency? Please specify the fixed amount in USD (payable in payroll currency): $_______________

UNICEF Authorization for Direct Deposit of MPO Form UNICEF (12/11)

1. I hereby advise UNICEF of my banking preferences and currency distribution. 2. Until further notice, make payment of all amounts due to me by UNICEF into my bank account(s) indicated above. 3. I understand that I am responsible for the accuracy of above information. 4. I am responsible for promptly notifying UNICEF of changes in the above information. 5. I understand these instructions will be in effect for a minimum of six (6) months, except for reassignment. 6. These instructions are effective from Bank instructions cannot be backdated. (dd.mm.yyyy)

Signature Signature Date (dd.mm.yyyy)