Direct Deposit Authorization - Community Financial Credit ...

[Pages:1]Thank you for trusting Community Financial with direct deposit of your paycheck. To complete the process, please complete and present this form to your employer's payroll department. If you have any questions please call Community Financial Credit Union at (877)937-2328.

Authorization to Establish or Change Direct Deposit of Payroll at Community Financial

Today's Date ______________ Name of Direct Depositor ___________________________________________________________________ Direct Depositor Street Address or P.O. Box ____________________________________________________ City __________________________________ State_______ Zip ______________

On ___________________ I closed my Checking Account at ____________________________________

Month/Day/Year

Name of Financial Institution

Old Acct. # ______________________ Account Holder ___________________________________________

New Financial Institution Information

Financial Insititution __C_o_m__m__u_n_it_y_F_in_a_n_c_i_a_l _C_re_d_i_t_U_n_i_o_n____ Routing # __2_7_2_4_8_3_7_4_3__________

Address __5_0_0__S_._H_a_r_v_e_y___P_l_ym__o_u_t_h___M_I___4_8_1_7_0____ Phone Number _(_8_7_7_)_9_3_7_-_2_3_2_8_o_r__(7_3_4_)__4_5_3_-1_2_0_0_

Account Number ____________________________

Checking

Savings

*I have enclosed a Deposit Slip/Voided Check to verify the account number.

Please establish Direct Deposit into my account effective as of ______/______/_______.

Signature ________________________________________ Daytime Phone Number __________________

COMPLETE THIS FORM FOR EACH COMPANY OR ORGANIZATION WITH WHOM YOU HAVE AN ARRANGEMENT FOR AUTOMATIC DIRECT DEPOSIT. PLEASE VISIT FOR ADDITIONAL FORMS.

500 S. Harvey, PO Box 8050 | Plymouth, MI 48170 | Phone (877) 937-2328 | Fax (734) 582-8905 |

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