Direct Deposit / Payroll Deduction Notification

Member Name *

Street Address *

City *

State *

Zip Code *

To: White Crown Federal Credit Union • PO Box 3060 • Denver, CO 80201 • Phone: 303-534-4448

Routing # 302076295

Account # *

Checking

OR

Savings

I hereby authorize this change in my direct deposit upon receipt of this form.

Signature *

clear

Date * +

Please give this form to your Employer’s Payroll Administrator.

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