L&N

L&N

FEDERAL CREDIT UNION

9265 Smyrna Pkwy ? Louisville, KY 40229

DIRECT DEPOSIT AND PAYROLL DEDUCTION

Provide this form to your employer to enroll in direct deposit or payroll deduction.

Name

MEMBER INFORMATION

Date

Routing # 283079227

MEMBER ACCOUNT INFORMATION Direct Deposit or Payroll Deduction Amount: $

Deposit To Account:

Savings

Member Number:

Deposit To Account:

Checking Full Share Draft Conversion #:

Full Share Draft Conversion #

3/15

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