Payroll Savings Application ***This form must be filled in BLACK INK for electronic imaging*** You can have three bond accounts either all Series EE, Series I or any combination. To initiate a new bond account, complete section 1 through 12. To change your bond accounts refer to your check stub to determine which bond you would like to change or cancel. If you are adding a new bond, check the next available number. If you are unsure, call Central Payroll Bureau at 410-260-7401. To cancel a bond account you must fill out sections 1 through 5 and block 7. For all actions you must fill out Blocks 1-5 Employee Information Block 1: Agency Number - This number can be found on your check stub. Block 2: Employee Social Security Number Block 3: Employee Name Block 4: Type of Payroll that you are paid on (RG- Regular, CT- Contract, and UM - University of Maryland) Block 5: Signature of Employee, Daytime phone number and date. Specific Bond Information Block 6: Deduction amount per pay - fill in the amount you want deducted from your paycheck for this bond account. Block 7: The action for Bond 1, 2 or 3 Block 8: Choose either bond series EE or I Block 9: Under bond series EE or I choose the bond denomination Block 10: Owner's name and social security number are required Block 11: Co-owner's name OR (You may have co-owner or beneficiary, not both.) Block 12: Beneficiary's name You are done completing this form unless you want additional bonds. If so continue filling blocks 6 through 12 for bond # 2 & 3. Print completed form and mail to: Central Payroll Bureau 108 Carroll Street P.O. Box 2396 Annapolis, Maryland 21404-2396 |