Print, complete and give this form to your payroll department.
(Your Direct Deposit will be activated within 4-6 weeks.)

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Dear Payroll Administrator, please initiate Direct Deposit for:
My Entire Check
$__________.00 Per Pay Period
(check only one)

Please deposit to my:
Checking
Savings
(check only one)

Citizens Federal Credit Union Account Number: ______________________________
Please list your account number as it appears on your statement.

For deposits to checking: attach a deposit slip or voided check.

At:
Citizens Federal Credit Union
PO Box 425
701 E FM 700
Big Spring, TX 79721-0425

Routing & Transit Number/ABA: 3 1 1 3 9 0 1 4 0

Name (Please Print): _____________________________

Signature & Date: _______________________________

Dear Payroll Administrator:
These specifications are to be used when your payroll processing system creates an electronic entry to the Automated Clearing House for processing. If you have any questions, please contact us at (800) 248-2328.