Direct Deposit Form

	Direct Deposit Form Please complete the direct deposit form and forward it to your payroll department for faster processing.

Authorization Code:

New

Change

Cancel
I authorize you and Auto Workers FCU to initiate electronic credit entries,
and if necessary, debit entries and adjustments for any credit entries in error to my:

Checking Account #		$
Savings Account #		$

each pay period. This authority will remain in effect until I have cancelled it in writing.

Financial Institution Information

Account Holder Information

Financial Institution: Auto Workers FCU

Name (Please print):

Address: 6010 Mountain View Drive

SS#:

City, State, Zip: West Mifflin, PA 15122

Signature:

Employer Name:

Date:

Address:

City, State, Zip:

243380451
TRANSIT ROUTING NUMBER (ABA)

STAPLE VOIDED CHECK HERE.