Direct Deposit Authorization - AdventHealth Credit Union

Direct Deposit Authorization

Our records indicate that a portion of your paycheck is currently sent to the Credit Union via Payroll Deduction. With the conversion to the new HR Payroll software, payroll deductions will stop.

By completing this form, you are authorizing your current payroll deduction be converted to direct deposit. This will ensure that your scheduled deposits/payments to AHCU are not interrupted.

Instructions to complete this form: ? Please print legibly. ? Only one account field allowed per form- Saving or Checking. ? If you have more than one payroll deductions scheduled to go to AHCU, please contact us via email or phone before completing this form, to ensure that your funds are routed accurately. Email: Fh.Credit.Union@ Phone: (407) 303-1527 Option 2. | Fax: (407) 303-0921

IMPORTANT: Please note that the TOTAL AMOUNT field below is the amount that will be deducted each paycheck. Different amounts per pay are no longer supported.

Name

Employee ID

Financial Institution NAME Account Number CHECKING Account Number SAVING AHCU Routing Number

ADVENTHEALTH CREDIT UNION

OR

263181287

TOTAL AMOUNT to be $ deducted each paycheck

___________________________________________ Signature

_____________ Date

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