GenFed Payroll Deduction

Use this form to speed up the process!

Using the "Print" link in the upper right corner of this page, print out and mail a signed copy of this to your local branch.

Name:  SSN:   Employer:

I hereby request GenFed Federal Credit Union to initiate credit entries and, if necessary, debit entries and adjustments for any credit entries in error to my account listed below. 

This authorization REPLACES all previous GenFed direct deposit authorizations and should begin with my pay of (m/d/y) //  OR as soon as possible.

Account # at GenFed Credit Union in Akron, Antwerp, Lorain, Bryan, Centralia, Fairlawn, Mt. Vernon, Sheffield Lake, Shelbyville or Wadsworth.

R&T/ABA 2412-7326-9

Deposit my entire (net) pay  OR Deposit a set amount of  $

My Deposit is to go to Checking OR Savings (check only one) and will be DISTRIBUTED to other accounts as noted below. 

This authority is to remain in full force until my employer has received written notification from me of its termination or change in such time and manner as to afford my employer a reasonable opportunity to act on it.

I have authorized my pay department to deduct the amount shown above from my pay each payday for deposit into GenFed.

DISTRIBUTION OF FUNDS

S1, S2

$

S20, S22, S23

$

S8, S10, S11, S9, S13, S17

$

S12, S14

$

S31

$

S30

$

$

$

Other

$

Signature:   _______________________

Date Signed: _____________________