Enter quick description of your request
Enter today's date
Enter your name
Enter your employee ID number
Enter your street address
Enter your Apartment/Unit # (leave blank if not applicable)
Enter your city
Select your state
Please enter your zip code
Enter your start date with Titan
Please enter the last four digits of your social security #
Enter your date of birth
Are you a Union employee?
You will be eligible to contribute to the 401(k) once you meet your six (6) month anniversary. Check the appropriate box and, if applicable, fill in the percentage/amount that you elect to contribute to each pay period to the plan through payroll deductions. Note: you may not exceed certain limits. For details please see plan highlights or the 401k website: www.myaccount.ascensus.com/ml.
Would you like to contribute a percentage (up to the maximum permitted by the plan) or a specific $ amount?
Would you like to contribute a percentage (up to the maximum permitted by the plan) or a specific $ amount? NOTE: Per Article X Pension of the Metropolitan Chicago Security Agreement Roth 401(k) Deferral is not available to union employees
Enter the percentage or exact dollar amount you would like to contribute per pay period.
Please enter your account manager's name
Please enter the name of your bank.
Enter the city and state location of your bank.
Please enter your bank account #
Enter your bank routing/transit number.
If depositing to a savings account, ask your bank to give you the Routing/Transit Number for your account. It isn't always the same as the number on a savings deposit slip. This will help ensure that you are paid correctly. The last item must be for the remaining amount owed to you. Make sure to indicate what kind of account, along with amount to be deposited, if less than your total net paycheck.
Enter the amount you would like deposited to the first bank listed per pay period.
Please enter the name of the second bank for your direct deposit.
Enter the city and state location of your second bank.
Please enter your bank account # for Bank #2
Enter your bank routing/transit number for Bank #2
Would you like to deposit the remaining net amount into this account?
Please enter the $ amount you would like deposited into bank account #2
Please enter the name of the third bank for your direct deposit.
Enter the city and state location of your third bank.
Please enter your bank account # for Bank #3
Enter your bank routing/transit number for Bank #3
Please enter any additional details of your request -- this includes any hours missed for paycheck issues or the date of any discrepancies in hours worked. If you are submitting a direct deposit cancellation, please submit each bank's cancellation separately. A member of our support staff will respond as soon as possible. If there is no additional information to add, please type "NA".
TYPE "YES" IN THE BOX TO AGREE TO THE FOLLOWING: I hereby authorize my employer to deposit any amounts owed me by initiating credit entries to my account at the financial institution(s) (hereinafter "Bank") indicated on this form. Further, I authorize Bank to accept and to credit any credit entries indicated by my employer to my account. In the event that my employer deposits funds erroneously into my account, I authorize my employer to debit my account for an amount not to exceed the original amount of the erroneous credit. This authorization is to remain in full force and effect until my employer and Bank have received written notice from me of its termination in such time and in such manner as to afford my employer and Bank reasonable opportunity to act on it.
By checking the box, you agree to the following: I authorize my employer to cancel any amounts to be deposited to the entered financial institution effective immediately. I understand this written notice is not effective until payroll confirms it has been received.
By clicking the box, you agree to the following: I understand: 1) In order to make my investment elections I must call 888-800-5359 or go to www.myaccount.ascensus.com/ml (see instructions included in benefit guide) 2) If I do not enter any investment elections my total account balance and all future contributions will be invested in into the plan's default investment option.
By clicking the box, you agree to the following: I understand the contributions I have authorized will remain in effect until I elect to change them in writing by completing a Change Form or through the 401k website www.myaccount.ascensus.com/ml. I understand any payroll deduction will go into effect the first pay period after my eligibly date (six month anniversary). I understand that my account is subject to all terms and conditions of the plan.