|
||||||||||||||||||||
View Your Accounts
Checking Accounts & |
|
EZ Switch
Authorization to Change Automatic Payment
Complete this form for each company or organization with whom you have arranged for automatic payment. You may make copies of this form or call 800-950-0236 for additional forms.
Re: Your Name, Address and Account Number with this Company
To Whom It May Concern: Print Name of Financial Institution Effective Date of Account Closing Old Account Number Name on Account Social Security Number I hereby authorize automatic payment from my new checking account at Acacia Federal Savings Bank, 7600 Leesburg Pike, East Bldg. Suite 200, Falls Church, VA 22043
New ABA Routing Number for Acacia Federal Savings Bank: 256073328 New Account Number with Acacia Federal My Signature Daytime Phone Number Date |