I, __________________________, hereby authorize _________________________________ to initiate automatic
deposits to my account at the financial institution named below. I furthermore, authorize you and WEPCO Federal Credit
Union to initiate electronic credit entries, and if necessary, debit entries and adjustments for any credit entries in error to
my account listed below.
This agreement will remain in effect until I, __________________________, and WEPCO Federal Credit Union receives a
written notice of cancellation from me or until I submit a new direct deposit form to the Payroll Department.
Name of Financial Institution:
WEPCO Federal Credit Union
(Exclude Share ID)
Authorized Signature (Primary):
Authorized Signature (Joint):
Please attach a voided check or deposit slip and return this form to the Payroll Department.