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Direct Deposit/Payroll Deduction Form PLEASE PRINT I hereby authorize my Employer Employee/FSFCU Member name to create a new payroll deduction or make the following changes to my existing payroll deduction which is deposited into my account at First South Financial Credit Union. Please check only one Start direct deposit of my NET PAY into my FSFCU account using the account number provided. Start a new payroll deduction in the amount of and deposit the funds into the following account number at FSFCU Change my existing deduction from to. Once your payroll deduction is deposited into your savings or checking account FSFCU can automatically distribute the funds into more than one account. If you would like to set up an automatic distribution please indicate below how you would like the funds distributed Savings Checking Christmas Club Vacation Club Employee Name Social Security No Address Phone Date of Birth City/State Zip Employer Employer Phone Employer Address Employee Signature Zip Date For composite or individual check please mail to For ACH/EFT Incoming Credits First South Financial Credit Union 6445 Stage Road Bartlett Tennessee 38134 ABA Routing 284085375 THANK YOU. Once your payroll deduction is deposited into your savings or checking account FSFCU can automatically distribute the funds into more than one account. If you would like to set up an automatic distribution please indicate below how you would like the funds distributed Savings Checking Christmas Club Vacation Club Employee Name Social Security No Address Phone Date of Birth City/State Zip Employer Employer Phone Employer Address Employee Signature Zip Date For composite or individual check please mail to For ACH/EFT Incoming Credits First South Financial Credit Union 6445 Stage Road Bartlett Tennessee 38134 ABA Routing 284085375 THANK YOU.

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