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ELECTRONIC PAYMENT SERVICE CREDIT AUTHORIZATION AGREEMENT

Please call 587-2700 if you have any questions about completing the Electronic Payment Authorization Agreement.
Requirements:
  • Monthly recurring credits (no utility payments)
  • $100 in your Regular Share Account
  • Account established at another financial institution. You must be the account holder at the financial institution receiving the credit and be the one to sign the Electronic Payment Service Credit Authorization Agreement
  • Credit to personal accounts only (no business)
  1. Please read the agreement carefully before signing - Sign and date the form.
  2. HSFCU Account Number - Enter your HSFCU account number where the funds will be withdrawn monthly to credit your account at the other financial institution.
  3. Sharecheck or Savings - Select the sub-account where the funds are to be withdrawn to send the credit to your other financial institution.
  4. Name - Your name.
  5. '
  6. Daytime Phone Number - A phone number where you may be reached during the day in case we have to contact you
  7. Name of Bank, S&L or Credit Union - The name of the other financial institution.
    This information is necessary in case we have to contact the other institution.
  8. Account Number/Loan number to credit - Your account or loan number at the other financial institution, which will be credited. Please be sure that the number is legible
  9. Loan note number/suffix - Your loan note number or loan suffix at the other financial institution, which will be credited. (if applicable)
  10. Share suffix - Your share suffix at the other financial institution, which will be credited. (if applicable)
  11. Amount of Payment - Enter the dollar amount for the monthly recurring credit.
  12. Type of Account - Select the type of account that will be credited at the other financial institution; ONLY ONE (1) may be selected. If you wish to credit multiple types of accounts at the same financial institution, please submit separate Authorization Agreements for each type of account. Each transaction will be handled separately.

    Submit a copy of a document displaying the account number or loan number to credit at the other financial institution. This will ensure proper crediting of your account.

    • Regular Shares will not have any documentation to obtain
    • Voided Check or Copy for all credits to a checking account. VERY IMPORTANT: Ask member for a voided check or make photocopy of check. If photocopy, stamp "COPY NOT NEGOTIABLE" across check making sure that the MICR line is legible. The copy will provide a verification source for ESS (no deposit slips allowed)
    • Loan statement
    • Loan coupons
    • Credit Card Statement
    • Bank statements
  13. Start Payment On - Enter the start date of the first payment. Must correspond to the selected payment date.
  14. Select Payment Date - Choose one of the payment dates offered. Select the payment date you want your account or loan to be credited.
  15. Sign and mail the agreement to:
Hawaii State Federal Credit Union
Attn: Webmail
P.O. Box 3072
Honolulu, HI 96802-3072

Authorization for Electronic Payment Service (Credit)
I authorize Hawaii State Federal Credit Union (HSFCU) to automatically deduct payments from my account at HSFCU and send such payments to my account at the financial institution indicated below and on the payment date selected. I acknowledge that the electronic payment transactions must comply with the provisions of U.S. law. I also acknowledge that this authorization is to remain in effect until HSFCU receives my written cancellation in such time and manner as to afford HSFCU reasonable opportunity to act on it; and that, HSFCU retains the right to cancel this authorization at any time and a new authorization must be submitted to reinstate the service. I understand that I am responsible for any loss or penalty that may incur due to Non-Sufficient Funds or other conditions in my account at HSFCU that may prevent the payment of funds to my account at the financial institution indicated below. I also understand that the funds will be withdrawn from my account one business day BEFORE the payment is sent to the financial institution indicated below. I further understand that if the payment date falls on a weekend or holiday, the payment will be deducted from my account on the day BEFORE the last business day prior to the weekend or holiday.

___________________
Signature

Date

HSFCU Account Number
ShareCheck Savings

Name

Daytime Phone

E-mail Address

Name of Bank, S&L or Credit Union

Account/Loan Number to Credit

Loan note number/suffix

Share suffix
$
Amount of Payment

Start Payment on (date)

Select One Payment Date:
1st 5th 7th 10th 15th 20th 22th End of month
Type of Account:
Checking
Home Equity Loan
Installment Loan
Mortgage Loan
Savings