Direct-Deposit Change Form

Friday, January 27, 2017 11:33:00 AM

Ready For Banking at Raymond Federal Bank Direct Deposit Change Form

Date
Company Making Direct Deposit
Address

To whom it may concern:

Please be advised that I am closing the existing account to which you are authorized to make a: Payroll Retirement/Annuity Dividend Other Direct Deposit

This notice authorizes you to establish this direct deposit to my Raymond Federal Bank account as of

New Account Information: Raymond Federal Bank

Account Type: Checking Savings

Routing Number
Account Number

Attached is a voided check for your reference.
If you have any questions regarding this request please contact me during the day or evening at

Phone Number

Thank you,

Customer SignatureX________________________________________
Printed Name
Date
Joint Signature if ApplicableX________________________________________
Address

Print this form: Complete, sign and submit it to the appropriate business to change any existing direct deposits to your Raymond Federal Bank account. You can call the Social Security office from any RFB branch location to change SSA/SSI deposits.