Eagle
Federal
P.
O. Box 64630 Baton Rouge,
LA 70896
225-927-1900 or
888-281-8485
DIRECT DEPOSIT
ALLOCATIONS
Submit this form
along with your new Direct Deposit enrollment form or to make allocation changes to current
Direct Deposits.<![endif]>
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Name |
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Social Security Number |
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Home Telephone |
(
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Work Telephone |
( ) |
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Source of Direct Deposit |
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Account
Type |
Account Number |
Amount |
Social
Security Number & Name
on Account if other
than you own. |
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Share Savings |
001 |
$ |
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Share Savings |
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$ |
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Share Savings |
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$ |
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Checking |
002 |
$ |
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Checking |
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$ |
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Visa Payment |
141 |
$ |
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Loan Payment |
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$ |
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Loan Payment |
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$ |
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Loan Payment |
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$ |
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Other |
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$ |
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Total Allocations |
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$ |
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By signing below, I authorize
Eagle Louisiana Federal Credit Union to allocate my direct deposit to the
accounts/loans designated above.
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Signature |
Date |