Fillable Printable Georgia's Own Direct Deposit Form - Georgia

Georgia's Own Direct Deposit Form - Georgia

Georgia’s Own Credit Union

1155 Peachtree Street

P.O. Box 105205

Atlanta, GA 30348

tel 404.874.0777

toll-free 1.800.533.2062

georgiasown.org

Georgia’s Own Direct Deposit Form

Employer Information:

Employer/Company name

Employer Address City State Zip

Personal Information:

Name

Address City State Zip

Funds will be deposited in the account(s) and information stated below:

Type of Account: Checking Savings Investment Account

Routing number: 261071438

Account number:

Amount: Net Pay or % or Dollar Amount

“I authorize to schedule a direct deposit as listed above”

Signature: Date: