Omaha Federal Credit Union's
Automatic Payment/Deposit Authorization

(For Payment From Omaha FCU)

I hereby authorize Omaha Federal Credit Union, hereinafter called CREDIT UNION, to initiate a debit entry from my (our) account indicated below at Omaha Federal Credit Union to
I (We) acknowledge that the origination of ACH transactions from my account must comply with the previous of U.S. law.

Omaha Federal CU Payment Information

MM slash DD slash YYYY
Payment Frequency (Pick One)

Destination Information

NAME ON ACCOUNT:
Address
Account Type:
This authorization is to remain in full force and effect until the CREDIT UNION and DESTINATION a reasonable opportunity to act on. Omaha Federal can terminate this contract at any time for insufficient funds activity.
Name
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MM slash DD slash YYYY

Please note: There will be a $15.00 fee for an add/change/delete.


Max. file size: 32 MB.
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