Retiree Premiums Bank Debit Payment Authorization
Description: Used by UTSA retirees to enroll in a bank debit service to automatically pay for out of pocket insurance premiums.
Last Revised On: 02/28/2013
Owner/Host: Payroll Services
Download File: PDF
Related Financial Management Operational Guideline(s) (FMOG): No related operational guidelines.
02/28/2013: Fixed error with not being able to enter account #.
07/19/2011: Completed minor grammatical edit in the Action Type section.
09/01/2010: Added new form.
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For technical/design issues or questions, contact the Financial Affairs Webmaster.