Authorization Form for Loan Payments

Authorization Form for Loan Payments

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I (we) hereby authorize Chief Financial to initiate a debit entry to my/our:

Savings
Checking
Visa / Mastercard

Financial Institution Transferring From:

Transferring to Chief Financial:


Contact Information:

Select Transfer Type:

Please cancel the above payment effective immediately.
*Note: 3-5 business days prior to transfer are needed before cancellation can be processed

   I have read and accept the Terms and Conditions

   I have read and accept the Terms and Conditions

   I have read and agree to the terms of the Electronic Signature Act Disclosure available at the link below.

E-Sign Act Disclosure

I also agree that the Internet access device(s) I/we will use to receive the related legal disclosures, agreements, online account loan payment form and the instructions meet(s) the system requirements described in the disclosure presented above; and I/we consent to receiving the related legal disclosures, agreements, online account signature form and the instructions electronically.

I authorize Chief Financial Federal Credit Union to initiate the above entry(s) to my account. This is an authenticated authorization that serves as an electronic record, which is a contract or other record created, generated, sent, communicated, received, or stored by electronic means. I have signature authority to this account or have been authorized by an individual who has signature authority to this account to authorize this entry.

Please Note: There will be a $35 fee charged to your Financial Institution for any returned payment.

Please click Authorize Payment to submit your payment information.