You can submit this form electronically in Online Banking.
Log in and click on the "Online Forms" tab and then click on the name of the desired application or form. Some "Online Forms" are partially auto-populated for your convenience.
Star One Recurring Authorization Agreement for Electronic Payment
General Information
Transfer Type (Select One)
Transfer Information
Other Financial Institution Information
I authorize Star One Credit Union to originate Electronic Funds Transfer transactions between the Credit Union and the other Financial Institution indicated above. This authorization is to remain in full force and effect until the CREDIT UNION receives my WRITTEN NOTIFICATION of its termination at least (3) three business days before the scheduled date of transfer in order to be effective. This authorization must be provided to the Credit Union at least 10 days before a new or existing payment takes place. A $13.00 fee will be charged to the above Credit Union savings or checking account for each item returned. The Credit Union may terminate this agreement if the Credit Union receives (3) NSF's for the same account number or otherwise if I fail to comply with my Membership and Account Agreement. A one time set up fee of $5.00 will be charged for each new request.
I further acknowledge that any electronic fund transfers initiated will not violate provisions of U.S. Law, including the requirements of the Office of Foreign Asset Control (OFAC). Some restrictions apply; all requests are subject to approval.
Please note that when your scheduled payment/transfer date falls on a weekend or non-business day, your payment/transfer will occur on the business day prior to your actual transfer date.
Member Signature: _______________________________Date: ________________
For Credit Union Use Only
| Form Received by: (Initial & Teller#) |
|
Date: |
|
| Processed by: (Initial & Teller#) |
|
Date: |
|
| Verified by: (Initial & Teller#) |
|
Date: |
|
REV: 08/17/2012
