Authorization
for Direct Payroll Deposit
Checking Account
Member Signature
Date
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|
|
Authorization
for Direct Payroll Deposit
|
|
| Name | |
| Social Security # | |
| MMCU Routing # | |
| Account # | |
|
Savings Account Checking Account |
|
| I hereby authorize to initiate credit entries (deposits) into my account with MOLINE MUNICIPAL CREDIT UNION (MMCU). MMCU is authorized by me to credit my account for the amount of those entries. This authority is to remain in full force and effect until has received written notification from me of a change in such manner as to afford a reasonable opportunity to act upon it. | |
| ___________________________________ Member Signature |
___________________________________ Date |
| Should you have any questions, please contact Moline Municipal Credit Union at (309) 797-2185 | |