DIRECT PAYROLL DEPOSIT REQUEST

Thanks to an employee benefit called Direct Payroll Deposit, you can have your paychecks deposited directly to your individual account(s) In the bank(s) of your choice:

1. You may have your net pay deposited to any bank, credit union, or savings and loan association that is a member of an automated clearing house system anywhere in the United States (limit to three accounts.

2. Your personal account(s) will be credited automatically on Thursday (payday Late time cards and computer rejects from the normal weekly payroll will be credited to your account(s) on Friday.

3. You will receive an earnings statement each week, listing all pertinent information regarding your salary and bank deposit(s).

In order to take advantage of this Direct Payroll Deposit, complete the information below authorizing The Walt Disney Company or Subsidiaries to deposit your paycheck directly to your personal bank account(s).

1. Enter your Origin Number.

2. Enter Department Number.

3. Print your Last Name, First Name, and Middle Initial.

4. Enter one of the following Activity Codes:

1. This is a New Direct Payroll Deposit.

2. I want to Change my Direct Payroll Deposit.

3. Please Cancel my Direct Payroll Deposit.

5. Enter your Social Security Number.

6. Print your Complete Bank Name(s) including the Branch Name(s) such as Bank of America NT & SA, Toluca Lake Branch and the amount to be desposited. You are limited to three accounts. If you wish the entire amount of your paycheck to be desposited into just one account, list that account on the first line and place the word "ALL" in the amount space. If not, enter the amount you wish to deposit into the first two accounts and then remainder of your check will be deposited into the account listed on the third line.

7. If this is a Checking Account, put a "C" in this space. If this is a Savings Account, put an "S" here. Attach a blank check for your checking account. Enter your savings account number below. Savings Account Number: ____________.

8. Sign the form and fill in Ext. and Today's Date.

9. Return completed form to the Payroll Department.

Name*

First Name & Middle InitialLast Name

Email (for receipt)*

example@example.com

Origin Number (if known)

Department Number (if known)

Social Security Number*

Bank Name & Branch #1*

Amount (or %) to send to Bank #1*

Checking (C) or Savings (S) for Bank #1*

Routing Number for Bank #1*

Account Number for Bank #1*

Bank Name & Branch #2

Amount (or %) to send to Bank #2

Checking (C) or Savings (S) for Bank #2

Routing Number for Bank #2

Account Number for Bank #2

Bank Name & Branch #3

Amount (or %) to send to Bank #3

Checking (C) or Savings (S) for Bank #3

Routing Number for Bank #3

Account Number for Bank #3

I hereby authorize The Walt Disney Company or Subsidiaries to automatically deposit my net pay each week to the bank account(s) listed above.

In the event an error on the part of the Company initiating credit to my account(s I authorize the Company tomake adjustments to correct such error and waive all rights to proceed against the receiving bank(s) on any adjustments made.

l understand that it is my responsibility to notify the Company of any changes in the status of my personal accounts and that any changes instituted by me, by submitting a revised Direct Payroll Deposit Request. will not be effective until the third week following the submitting of the request.

Signature

Date*

Date