Direct Deposit Form

Complete this form, then print it out and deliver it to your company payroll department.

Date:

Diversified Credit Union
ABA Routing Number: 291074748

Member Name:

Where would you like your money deposited:

Checking:
Enter the MICR #, the second set of numbers at the
bottom of your personal checks.

Savings:
Enter your Member #


Deposit Full Check Amount

Deposit Specific Amount of: $

Split Deposit Amount As Follows: $ in Checking and $ in Savings

Signature: _________________________________________________________


NCUA

 
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