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Direct Deposit Form

Complete this form if you need a direct deposit form to take to your employer/corporation. Print, sign, and submit it to your employer/company for processing.

Personal Account
First Name
Middle Name or Initial
Last Name
Email Address
Street Address
City
State                Zip Code:
Phone Number
ACU Account Number
Account Type Savings Account     Checking Account
Name of Payor (Company/Employer)
Address
City
State                Zip Code:

Payee/Joint Payee Certification

I certify that I am entitled to the payment identified above, and that I have read and understand this form. In signing this form I authorize my payment to ACU to be deposited to the designated account.


Signature _______________________________________________ Date ______________


Signature - Joint Signer _________________________________ Date ______________


Financial Institution

Alliant Credit Union
1200 Associates Drive, Suite 102
Dubuque, IA 52001-4848
Phone: 563-585-3737
Toll Free: 1-800-928-4328

Routing Number: 273974633

ACU agrees to receive and deposit the payment identified above in accordance with 31 CFR Parts 240, 209, and 210.

Cancellation

The agreement represented by this authorization remains in effect until canceled by you with your company/employer. Upon cancellation, you should notify ACU that you are canceling. This agreement may also be cancelled by ACU by providing you a written notice 30 days in advance of the cancellation date.

Change Receiving Financial Institutions

Your direct deposit will continue to be received by ACU until you notify your company/employer that you wish to change the financial institution receiving the direct deposit. To effect this change, you need to complete a new direct deposit form. It is recommended that you maintain accounts at both financial institutions until the transaction is complete, i.e. after the new financial institution receives your direct deposit.