MUNICIPAL CREDIT UNION DIRECT DEPOSIT DISTRIBUTION REQUEST 45.50 05/31/19 ACCOUNT NUMBER DEPOSIT ACCOUNT NUMBER 1580663 | NAME EMPLOYER ID MR CLYDE WASHINGTON | SOCIAL SECURITY # PAYROLL GROUP TOTAL DEDUCTION TYPE 1D ; 1,086.12 SHARE 02 WEEKLY BEWEEKLY MONTHLY ACCOUNT# TYPE 1D | AMOUNT __| ACCOUNT# TYPE 1D AMOUNT $ Pe 21 45.50 $ is $ vs $ 3 $ $s $ vs $ $ $ 3 $ $ $ s $ $ $ is TOTAL DISTRIBUTIC REP. ARRION FLETCHER Il authorize Municipal Credit Union to distribute the direct deposit of my payroll or US government payment as noted on this form. [I understand that in order for the direct deposit of my paycheck or government payment to begin I must first complete and file a separate agreement with my employer or the appropriate government agency. If ever an incorrect amount should be deposited to my account(s). I authorize the Municipal Credit Union to make the appropriate adjustments. [ also acknowledge receipt of the Electronic Funds Disclosure statement. NOTE: Any portion of a direct deposit not specifically designated for distribution to a particular account will be deposited in to the account you designated on the direct deposit authorization form. Signature: Date__05/31/19 EFTA00124588