Workers Credit Union - Personal and Business Banking in Massachusetts

Forms

ACH Origination Setup - Use this form to transfer funds from another institution to Workers’ Credit Union. For a one-time transfer, a $5.00 fee is assessed for ACH transactions being initiated through Workers’ Credit Union. For reoccurring transfer to Workers’ Credit Union, there is no fee.

For reoccurring transfer from Workers’ Credit Union accounts to an external account, there is a $5.00 fee for each transaction, i.e., weekly, monthly, etc.

Forms may be mailed, brought to a branch or faxed to 978-345-4830 ATTN: ACH Department.

ACH Unauthorized Debits - This form is to be completed by a Workers’ Credit Union member who is reporting to us that an unauthorized ACH debit has occurred. Member must first contact the merchant to dispute the transaction then if unsuccessful an unauthorized form along with a signed letter of dispute can be sent to the ACH Department. This form can be faxed to 978-345-4830 and/or mailed to Worker’s Credit Union, Attn: ACH Card Dept, P.O. Box 8207, Fitchburg, MA 01420.

Affidavit with Respect to Deceased Depositor - Use this form to claim funds for a person who is deceased. Must be notarized. Must also provide a copy of the original death certificate and executer forms. Must be mailed in or brought to a branch office.

Affidavit of Alteration - Use this form to report and altered or fictitious check that cleared your account. Must be notarized and mailed or brought to a branch office.

Automatic (Direct) Deposit - Provide this form to your payroll company/department to set up direct deposit.

Change of Address - Use this form to change your address.

Combined Statements - Use this form to combine your account on one easy to read monthly statement.

Debit Card Fraud Affidavit - This form is completed by a Worker’s Credit Union member who is reporting to us that an unauthorized debit card transaction or transactions has occurred. This form can be faxed to 978-345-4830 and/or mailed to Worker’s Credit Union, Attn: Debit Card Dept, P.O. Box 8207, Fitchburg, MA 01420.

Electronic Access Request -Use this form to apply for a new debit card. May be mailed or faxed to 978-345-4830 ATTN: Debit Department. Also may be brought to a branch office.

Online Check Reorders from Deluxe Corporation - Reorder checks.

Online Withdrawal - Make a withdrawal from a statement account and have a bank check mailed to your address on file for your account.

Opt-in Form - Because of the new regulatory requirements, if you currently have Overdraft Privilege on your account the service you currently have for everyday ATM transactions and debit card purchases will only continue until August 15, 2010, unless you notify us that you wish to continue to receive the service for those transactions after August 15, 2010. Use this form to Opt-in.

Preauthorized Transfer Setup - Use this form if you would like to set up an automatic monthly transfer from one account to another. Used to transfer between internal accounts held at Workers' Credit Union only. To set up a transfer to or from another financial institution, please use the form titled ACH Origination Setup. You may fax this form to 978-345-4830, mail to PO Box 8207, Fitchburg, MA, or simply drop it by any Workers' branch office.

Preauthorized Withdrawal Revocation of Authorization - This form is to be completed by a Workers' Credit Union member who wishes to stop a reoccurring debit from your account. Fill out the stop payment form with the information of the merchant you wish to stop. Please be aware that we need 3 business days prior to the scheduled debit in order to guarantee the stop. A fee of $25.00 will be withdrawn from the account you provide. This form can be faxed to 978-345-4830 and/or mailed to Workers’ Credit Union, Attn: ACH Dept, P.O. Box 8207, Fitchburg, MA 01420.

Sign up for federal direct deposit - Direct deposit is the best way to get your Social Security and other federal benefit payments.

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Forms