Payroll Deduction Form (for CSULA employees)
To protect the confidentiality of personal financial information and signatures, California State University, Los Angeles Federal Credit Union requests that our members send applications via the following safe methods:
By Fax: Complete the information requested, then print out all pages of the application and fax to our secured number: 323-505-2613
By Mail: Complete the information requested, then print out all pages of the application and mail in a sealed envelope to Cal State L.A. Federal Credit Union Post Office: P.O. Box 1117, Montebello, CA 90640-1117
In Person: Bring the completed application to our office at the address above, and submit it confidentially to one of our specialists.

Start Change Account Number:

Name: Social Security Number:

Home Phone: Work Phone:

EMPLOYER: Cal State L.A. Only Send a total of each period to CSULA FCU.

 

Distribution:
ACCOUNT TYPE ACCOUNT NO. / SUFFIX $ AMOUNT
Savings
Checking
IRA
Holiday Saver

LOAN TYPE LOAN NO. / SUFFIX $ AMOUNT
Signature/LOC
Auto
1st T.D.
OTHER
     
TOTAL CSULA FCU

 
Signature

X_______________________________________________________ Date:_____________

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