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Deseret First Credit Union
PO Box 45046 Salt Lake City, UT 84145 |
PAYROLL DEDUCTION REQUEST
TO Deseret First Credit Union Phone: 456-7000 or 800-326-3328 Routing #: 324078909 |
| Employee's Name & Address:
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Social Security Number:
__ __ __ - __ __ - __ __ __ __ |
| Employer's Name & Address:
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Telephone:
Home: __ __ __ - __ __ __ __ Work: __ __ __ - __ __ __ __ |
| Account Number:
0 0 0 __ __ __ __ __ __ __ (For Example: If your account # is 12345-6, the number should be 0000123456) |
| TOTAL AMOUNT OF DEDUCTION per pay period to __ SAVINGS
- __ CHECKING (check one): $___________
The stated amount will be deposited to the specified account when received from your payroll. |
| I hereby authorize my employer to (check one) __ START, __ CHANGE, __ CANCEL deductions from salaries or wages due me in the amount specified above which are for remittance to Deseret First Credit Union, P.O. Box 45046, Salt Lake City, UT 84145 for credit to my account. |
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Employee's Signature __________________________________________________ Date ___________ |