State Employees' Credit Union®
I I
I
I I
I
Direct Deposit Authorization Form
Complete this form and take it to your Human Resources/Payroll office to initiate/change your Direct
Deposit.
Employer Information
Please complete the following information regarding the Employer.
Name:
Address:
City:
State:
Zip Code:
Phone Number:
Employee Information
Please complete the following information regarding the Employee.
Name: ID Number:
Social Security Number (SSN):
Address:
City:
State:
Zip Code: Phone Number:
New Direct Deposit Information
Please complete the following information regarding the Direct Deposit.
Name: State Employees’ Credit Union
Address: PO Box 26748, Raleigh, NC 27611
Routing Number: 253177049
Account Number: Account Type: Checking Share
I authorize (employer) to deposit my payroll check directly to the account listed above,
effective (date).
Employee Name:
Employee Signature: Date:
Updated 07-28-2020