1 Community Federal Credit Union

1st Community Federal Credit Union

3505 Wildewood Drive, San Angelo, Texas 76904 325/653-1465 or 800/749-1465

Change of Automatic Payment /Draft

To Now Come Out of Your 1st Community FCU Checking Account

You will be responsible for submitting this form to the debiting Company Once your checking account is established at 1st Community FCU, forward this form to all companies that are automatically drafting from your savings account. (Examples: mortgage, auto, insurance premiums, etc.)

(Please make as many copies of this form as necessary)

Company Info: To (Company)__________________________________________________________________ Address________________________________________________________________________ Fax ___________________________________________________________________________ Name account is listed under________________________________________________________ Company Account #_______________________________________________________________

I hereby authorize you to stop my current automatic draft from savings at 1st Community FCU and establish a draft on my checking at 1st Community FCU.

Credit Union Info: Name on CU Account_____________________________________________________________ 1st Community FCU Checking Account Number ____________________________________ 1st Community FCU Routing ABA # 311382527 Beginning Date of Draft _________________________________________________________

Signature _____________________________________________Date _____________________

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