FirstEnergy Family Credit Union Logo and Address

Payroll Deduction Form

There are two forms that need to be completed for a payroll deduction change. Make sure you scroll down and complete both forms.

1st page (Fill-in)

Name

Sap #

Phone #

Location Bi-weekly/weekly

Sign and date bottom of form

2nd page (Fill-in)

Name

Location

Account # (at FEFCU) SAP # Bi-weekly/weekly

Deduction amount for each account Sign and date the bottom

Mail both printed forms to:

Interoffice Location: A-FECU

Or

FirstEnergy Family Credit Union

Attn: Payroll

575 White Pond Drive, Suite E

Akron, OH 44320-1184

FirstEnergy Corp. Employee Payroll Deduction Form

 

 

Account Number

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

SAP Number

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Name

 

I am paid:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Check Payroll Frequency Below:

 

 

 

 

Location

 

 

 

 

Weekly

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Bi-Weekly

 

 

 

 

 

 

 

 

 

 

 

 

Day Time Phone Number

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

This form is for FirstEnergy Corp. employees.

Please indicate the amount per paycheck you would like deducted and allocated to the following accounts. All deductions must be listed, not just current changes.

Type of Account

Account # & Suffix

Amount

Type of Account

Account # & Suffix

Amount

 

 

 

 

 

 

 

Savings

 

 

Loan

 

 

 

 

 

 

 

 

 

Savings

 

 

Loan

 

 

 

 

 

 

 

 

 

Savings

 

 

Loan

 

 

 

 

 

 

 

 

 

Savings

 

 

Loan

 

 

 

 

 

 

 

 

 

Christmas Club

 

 

Loan

 

 

 

 

 

 

 

 

 

Plan-it Save for it

 

 

Other__________

 

 

 

 

 

 

 

 

 

Plan-it Save for it

 

 

Other__________

 

 

 

 

 

 

 

 

 

Plan-it Save for it

 

 

Other__________

 

 

 

 

 

 

 

 

 

 

Sub Total 1

 

 

 

Sub Total 2

 

 

 

 

 

 

 

 

 

 

 

 

 

Grand Total (Must Equal Sub Total 1 + Sub Total 2)

 

 

 

 

 

 

 

 

 

 

 

To FirstEnergy Corporation: I hereby authorize the FirstEnergy Family Credit Union to deduct from my pay the amount set forth above for transmittal to above named Credit Union as a credit to my account. This authorization cancels and supersedes any authorization heretofore signed by me and is to continue in effect until changed or cancelled by me in writing.

By signing the Payroll Deduction Allocation Form I understand that it is my responsibility to verify that all my deductions are posted properly. If any loan payments do not come out I understand that I am responsible for making the missed payment myself.

Signed By

MAIL TO:

US Postal Address

FirstEnergy Corp. Interoffice mail code

 

 

FirstEnergy Family Credit Union

A-FECU

 

ATTN: PayRoll

 

 

575 White Pond Drive, Suite E

 

 

Akron OH 44320-1184

 

FirstEnergy

DIRECT DEPOSIT AUTHORIZATION - PAYCHECK AND EXPENSE REIMBURSEMENTS

FORM 91 (REV. 09-10)

EMPLOYEE NAME

 

SAP NO.

 

 

 

DAYTIME PHONE NO.

LOCATION

CHECK ONE
WEEKLY BI-WEEKLY

 

 

 

AUTHORIZATION AGREEMENT

I authorize FirstEnergy Corp. to initiate credit entries and to initiate, if necessary, debit entries and adjustments for any credit entries made in error to the account(s) listed below.

For verification of my bank account information, I have attached a voided check (not a deposit slip), a photocopy of a check, or I have contacted my financial institution for the correct routing number and account number.

This authorization will remain in effect until my written notification of cancellation or change is received. Direct deposit authorizations will be effective as soon as reasonably possible following receipt by Payroll Services.

PRIMARY ACCOUNT INFORMATION

 

NEW

CHANGE IN EXISTING

CANCEL

 

 

FINANCIAL INSTITUTION NAME

 

 

 

CHECKING

 

SAVINGS

N/A

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

ROUTING NO.

 

 

ACCOUNT NO.

 

 

N/A

 

 

 

 

 

 

 

 

 

 

 

 

EXPENSE REIMBURSEMENT ACCOUNT INFORMATION

 

 

NEW

CHANGE IN EXISTING

CANCEL

SAME AS PRIMARY ACCOUNT INFORMATION

FINANCIAL INSTITUTION NAME

 

 

 

CHECKING

 

SAVINGS

N/A

 

 

 

 

 

 

 

 

 

 

ROUTING NO.

 

 

ACCOUNT NO.

 

 

N/A

 

 

 

 

 

 

 

 

 

 

 

 

OTHER ACCOUNT INFORMATION

 

 

 

NEW

CHANGE IN EXISTING

CANCEL

 

 

FINANCIAL INSTITUTION NAME

 

 

 

CHECKING

FLAT AMOUNT

FirstEnergy Family Credit Union

 

 

$

 

 

 

SAVINGS

 

 

 

 

 

 

 

 

 

 

 

 

 

ROUTING NO.

 

 

ACCOUNT NO.

 

 

241273104

 

 

 

 

 

 

 

 

 

 

 

 

OTHER ACCOUNT INFORMATION

 

 

 

NEW

CHANGE IN EXISTING

CANCEL

 

 

FINANCIAL INSTITUTION NAME

N/A

 

 

CHECKING

FLAT AMOUNT

 

 

 

$

 

 

 

 

SAVINGS

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

ROUTING NO.

 

 

ACCOUNT NO.

 

 

N/A

 

 

 

 

 

 

 

 

 

 

 

 

OTHER ACCOUNT INFORMATION

 

 

 

NEW

CHANGE IN EXISTING

CANCEL

 

 

FINANCIAL INSTITUTION NAME

 

 

 

CHECKING

FLAT AMOUNT

N/A

 

 

 

$

 

 

 

 

SAVINGS

 

 

 

 

 

 

 

 

 

 

 

 

 

ROUTING NO.

 

 

ACCOUNT NO.

 

 

N/A

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

SIGNATURE

 

 

 

 

 

DATE

 

 

 

 

 

 

 

FOR PAYROLL SERVICES USE ONLY

DATE RECEIVED

DATE ENTERED

ENTERED BY