Kansas Department of Administration

20-P-012 Addition of Direct Deposit Authorization Form to Employee Self Service (September 17, 2019)

Posted on October 21, 2021 at 12:51 PM by Kansas Department of Administration

Informational Circular No.


Effective Date:


Contact Name:
Amanda Entress

(785) 296-3887


Approval: Nancy Ruoff
(Original Signature on File)

Addition of DA-184 Authorization for Direct Deposit of Employee Pay and/or Travel and Expense form to Employee Self Service

As a result of the continued increase in reported fraudulent requests to update direct deposit information, the DA-184 Authorization for Direct Deposit of Employee Pay and/or Employee Travel and Expense form has been updated and moved to Employee Self Service (ESS).  This change limits access to the DA-184 form to active State of Kansas employees using the secure ESS portal. 

Effective immediately, the Rev. 09-2019 version of the form is the only authorized form that may be accepted by an agency to authorize changes to employee direct deposit information. The revised form reflects updates to the required agency certification section and a new revision date of 09-2019.  All previous versions of the DA-184 form are in the process of being removed from the public website.  Agency HR/Payroll/Fiscal offices with blank, paper copies of previous versions of the DA-184 form should shred the blank forms and access/print a new copy of the form from Employee Self Service to assist new employees with enrolling for direct deposit.

To access the revised form in Employee Self Service, click on the W4, K4, & Direct Deposit Forms Tile > Direct Deposit Form > View Attachment. The blank form can be printed and filled in by hand or the form can be completed online as a fillable .pdf form and printed.  The completed form must be signed by hand by the requesting employee and submitted to the employee’s agency HR/Payroll/Fiscal office for processing. Please note that electronic signatures are not accepted on the form.

All agency HR/Payroll/Fiscal staff are reminded that it is the agency’s responsibility to complete the DA-184 Section B: Agency Certification for all submitted DA-184 changes requested. Failure to verify the requested change, directly with the employee either in person or via a known phone number for the employee, carries a very high risk of entering a fraudulent direct deposit change which will result in a loss of funds to the agency if net pay or expense reimbursement is mis-directed and the funds are not recoverable.

Printable Version of 20-P-012


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