ACH Origination Master Agreement
An ACH (Automated Clearing House) Origination may be established to automatically deposit funds into a USC Credit Union
account. Funds will automatically be withdrawn from the account at the specified financial institution.
SECTION 1
(Transfer “From” Account)
Name of Account Holder (Last, First, M)
Name of Financial Institution
Address (Street, Route, P.O. Box, APO/FPO)
Type of Account
Checking
City
State
Zipcode
Money Market
Account Number
Telephone Number
Routing Number (ABA Number)
Frequency of Withdrawal
Amount of Withdrawal
[Semi-Monthly (1 &15 or 15& 31), Monthly, Biweekly, weekly or One time only]
Date of Withdrawal (If monthly, withdrawal will occur each month)
Savings
$
Password (Must be included for future, non-recurring transfers)
Authorization: By signing this form, I hereby authorize USC Credit Union to transfer funds from the account listed in Section 1 to the USC Credit
Union account listed in Section 2. USC Credit Union may also accept requests to initiate one time transfers with use of the password listed in Section 1.
____________________________________________
____________________________
Signature
Date
Fee Notice: ACH transactions less than $250.00 will result in a $1.00 fee assessed to the USC Credit Union account listed in Section 2.
SECTION 2
(Transfer “To” Account)
Name of Account Holder to Receive Deposit (Last, First M)
Name of Financial Institution
USC Credit Union
Address (Street, Route, P.O. Box, APO/FPO)
Type of Account
Savings
City
Telephone Number
State
Zipcode
Checking
Money Market
Loan Payment:
(loan #______)
Account Number
Routing Number (ABA Number)
322079557
Requests received by 3:00 PM will have funds credited to the recipient’s USC Credit Union account the next business day. If funds are
not available at the time of withdrawal, funds may not be available in the USCCU account of deposit. The USCCU account holder will be
responsible for any returned items or fees due to insufficient funds.
Automatic withdrawals may be discontinued by submitting a written request two (2) weeks prior to the scheduled withdrawal. This
agreement may be cancelled at any time with a written request from the account holder listed in Section 1. USC Credit Union reserves the
right to revoke this agreement at any time and will notify the account holder listed within two (2) weeks of revocation.