Automatic Funds Transfer Request

Member Name *

Phone *

Transfer from my Account Number *

Select the account type to transfer from:

Checking

Savings

Sub-savings

To my Loan Number *

Monthly on (day) *

In the Amount of *

Effective on (Date) *

Until I submit a written request to discontinue.

Make this payment: (Choose one)

Every time, no matter whether I'm behind or a payment is made in another way. (This option allows you to make additional payments).

Only if this payment is not made in another way.

Only if a payment is not made another way and pay enough to catch up my loan completely. (Payment will not transfer if you already have made a payment in another way.)

For loans that cannot be paid ahead (VISA, PLOC, HELOC etc.) make this payment every time. If the loan becomes delinquent, make transfers everyday until the loan is current.

By checking this box, I authorize SLOCU to make this automatic transfer.

For Office Use Only:

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