ACH Change Request

Submit this form to make a CHANGE to a current ACH between your IBEW UW FCU account and your account at another Financial Institution ONLY.

I understand that the change of notice must be given at least ten (10) business days prior to the scheduled date of the transaction.

Initial Here *

Member Name *

Member Account Type:

Share

Checking

Loan

Member Account # *

Account Suffix *

Change ACH Origination - continued

Change Name of other Financial Institution to:

Change Routing Number to:

Change Name(s) on account to:

Change Account Number to:

Share

Checking

Loan

Change the Frequency to:

Weekly

Bi-weekly

Monthly

Change the Amount Transfer to ($)

Change the day of the Week or Month the transfer is to occur

Effective Date of Changes

If changing bank routing & account number, you MUST provide a copy of a VOIDED check/bank letter verifying the authorized signer on the new account.

Upload Image of the front of a voided check or bank letter

Click or drag & drop image here to upload

Checking this box serves as my authorization to process my ACH Change Request.

FOR CU USE ONLY

Received by Employee ID

Processed by Employee ID

Date

Thank You