DIRECT DEPOSIT FORM

ACCOUNT NUMBER_________________________________________ DATE___________________________ NAME_____________________________________________________ SSN___________________________ 1st Choice Credit Union ROUTING # TO EMPLOYER:_____________________________________________ PAYROLL NUMBER:    I hereby authorize you to deduct the following from my pay until further notice, and transmit to the above named Credit Union. ____MONTHLY ____SEMIMONTHLY ____BIWEEKLY ____WEEKLY ____NEW ____CHANGE ____STOP ____REALLOCATE TOTAL DEDUCTION EFFECTIVE DATE CREDIT UNION EMPLOYEE Signature of Employee__________________________________ You Must Print, Sign, and Return to Credit Union