![]() |
Change of Address 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
Name
Sap #
Phone #
Location
Sign and date bottom of form
2nd page
Name
Location
Account # (at FEFCU) SAP #
Deduction amount for each account Sign and date the bottom
Mail both printed forms to:
Interoffice Location:
Or
FirstEnergy Family Credit Union
Attn: Payroll
575 White Pond Drive, Suite E
Akron, OH
FirstEnergy Corp. Employee Payroll Deduction Form
|
|
Account Number |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
SAP Number |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
||
Name |
|
I am paid: |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|||
|
|
Check Payroll Frequency Below: |
|||||||
|
|
|
|
||||||
Location |
|
|
|
|
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 |
|
|
|
|
|
|
|
|
|
|
|
|
Other__________ |
|
|
||
|
|
|
|
|
|
|
|
|
Other__________ |
|
|
||
|
|
|
|
|
|
|
|
|
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 |
|
|
ATTN: PayRoll |
|
|
575 White Pond Drive, Suite E |
|
|
Akron OH |
|
FirstEnergy
DIRECT DEPOSIT AUTHORIZATION - PAYCHECK AND EXPENSE REIMBURSEMENTS
FORM 91 (REV.
EMPLOYEE NAME |
|
SAP NO. |
|
|
|
DAYTIME PHONE NO. |
LOCATION |
CHECK ONE |
|
|
|
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.
|
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 |
|
|
|