Please return this completed request to your employer's human resources office for payroll direct deposit changes.
To:___________________________________________
(Your employer)
I have recently switched financial institutions and would like you to begin electronically depositing my paychecks into my Montana Educators' Credit Union account. Below is all the information necessary to make this change.
SECTION 1 - Direct Deposit Authorization
Name______________________________________________________
Social Security #_____________________________________________
Address_____________________________________________________
City, State, Zip_______________________________________________
Company Name______________________________________________
Company Address____________________________________________
SECTION 2 - Deposit Instructions
Deposit the of my net paycheck into my share draft account #010800_____________________ ABA 092981658
Deposit $___________of my paycheck into my share account #______________
and place the remaining amount into my checking account #_________________
SECTION 3 - Read and Sign Below
I hereby authorize:
· The above listed entity to initiate credit or debit (if necessary to correct an error) entries to my Montana Educators' Credit Union account(s) for the purpose of electronically depositing my paycheck.
· This authorization is to remain in full force and effect until I send a written notice of change or cancellation.
____________________________________________________
Signature & Date