CHANGE OF ADDRESS FORM
For
!
security purposes, all fields should be completed. Please print. Thank you
Name __________________________________________________________________________________________
Account number __________________________________________________________________________________
Old address ______________________________________________________________________________________
City, State, ZIP ___________________________________________________________________________________
Old home phone number
(
) _______ - ___________
Old work phone number
(
) _______ - ___________
Old e-mail address ________________________________________________________________________________
New address ____________________________________________________________________________________
Physical address required when changing address to a PO Box
City, State, ZIP __________________________________________________________________________________
☐
New home phone number
(
) _______ - ___________
Same as above
☐
New work phone number
(
) _______ - ___________
Same as above
☐
New cell phone number
(
) _______ - ___________
Same as above
☐
New e-mail address ________________________________________
Same as above
Employer or new employer ________________________________________________________________________
☐
☐
Order new checks?
Yes -- Number of boxes: ______
No
☐
☐
Prefer safer, secure e-statements?
Yes (requires enrollment)
No
Effective date of address change ____________________________________________________________________
Signed: _______________________________________________________________________________________
(Must be signed by an account owner.)
Today’s date
Please print legibly or type. When completed, mail or fax to: Alabama Credit Union, P. O. Box 862998, Tuscaloosa,
AL 35486-0027; fax 205-348-2338. NOTE: You must provide a copy of your ID when faxing or mailing. You may also
®
provide this information by logging on to your ACUiBranch
account at , choosing User Services, and
sending a secure e-mail to us. NOTE: For security purposes, there may be a delay in sending a replacement MasterCard
®
credit or debit card after your address change. For fastest service, use secure ACUiBranch
or visit a branch with your
valid photo ID to change your address or receive replacement MasterCards.
For credit union use only:
____ Account
____ New checks
____ MasterCard credit card
____ Debit MasterCard
____ Other: ____________________________
Completed by: ___________________________________
Date: _____________________________________
Department/Branch: ______________________________
Phone: ___________________________________