MUNICIPAL CREDIT UNION DIRECT DEPOSIT DISTRIBUTION REQUEST

MUNICIPAL CREDIT UNION DIRECT DEPOSIT DISTRIBUTION REQUEST ACCOUNT NUMBER DEPOSIT ACCOUNT NUMBER 1580663 NAME EMPLOYER ID MR CLYDE WASHINGTON SOCIAL SECURITY II PAYROLL GROUP 000000 TOTAL DEDUCTION TYPE ID S 1,086.12 SHARE 02 WEEKLY x BI-WEEKLY MONTHLY ACCOUNT. TYPE ID AMOUNT ACCOUNT'S TYPE ID AMOUNT LOAN 21 5 45.50 $ 5 $ $ $ $ $ $ $ $ $ $ $ 5 $ 5 $ $ $ $ $ $ $ TOTAL DISTRIBUTION AMOUNT DATE REP. I S 45.50 05/31/19 ARRION FLETCHER I authorize Municipal Credit Union to distribute the direct deposit of my payroll or US government payment as noted on this form. I understand that in order for the direct deposit of my paycheck or government payment to begin I must first complete and file a separate agreement with my employer or the appropriate government agency. If ever an incorrect amount should be deposited to my account(s). I authorize the Municipal Credit Union to make the appropriate adjustments. I also acknowledge receipt of the Electronic Funds Disclosure statement. NOTE: Any portion of a direct deposit not specifically designated for distribution to a particular account will be deposited in to the account you designated on the direct deposit authorization form. Signature: Date 05/31/19 EFTA00124588