LEYDEN CU DIRECT DEPOSIT FORM

 

Please complete and present the following form to your company payroll department to authorize automatic deposits or debits to be made to Leyden Credit Union through the Automated Clearing House (ACH):

Name______________________________________________________________________________

Address____________________________________________________________________________

City / St / Zip________________________________________________________________________

Soc. Sec. # _________________________________________________________________________

Account Number(s)___________________________________________________________________

[  ] Savings         [  ] Checking

Leyden Credit Union ABA number: 271984285

 

Company___________________________________________________________________________

Address____________________________________________________________________________

City / St / Zip________________________________________________________________________

 

I hereby authorize _____________________________, [Employer] to initiate credit entries (and if necessary, to initiate debit entries and adjustments for any entries in error) to my account and Leyden Credit Union to credit and/ or debit the same to such account.

 

 

________________________________               ________________________________

SIGNATURE                                                           DATE

 


LEYDEN CREDIT UNION l 2701 N 25TH AVE l FRANKLIN PARK, IL 60131

Phone 847-455-8440 l Facsimile 847-455-1245 l http://www.leydencu.org