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  1. Home
  2. Applications and Forms
  3. ACH Recurring Authorization Agreement

ACH Recurring Authorization Agreement

Recurring Authorization Agreement for Electronic Payment

Form Instructions

For loan payments, please use our Pay from an Outside Account service.

Please print this form, then sign, date and fax it to (408) 543-5203, Attn: Support Services, or mail it to:

Star One Credit Union
Attn: Support Services
P.O. Box 3643
Sunnyvale CA 94088-3643

Your Information

General Information


Transfer Type
Transfer to Star One CU from my personal account at another financial institution.
Transfer from Star One CU to my personal account at another financial institution

Transfer Information
Transfer Frequency:

Other Financial Institution Information
Account Type:

I authorize Star One Credit Union to originate Electronic Funds Transfer transactions between the Credit Union and the other Financial Institution indicated above. This authorization is to remain in full force and effect until the CREDIT UNION receives my WRITTEN NOTIFICATION of its termination at least (3) three business days before the scheduled date of transfer in order to be effective. This authorization must be provided to the Credit Union at least 5 business days before a new or existing payment takes place. A $ 15.00 fee will be charged to the above Credit Union savings or checking account for each item returned. The Credit Union may terminate this agreement if the Credit Union receives (3) NSF's for the same account number or otherwise if I fail to comply with my Membership and Account Agreement. A one-time set-up fee of $5.00 will be charged for each new outgoing request.

I further acknowledge that any electronic fund transfers initiated will not violate provisions of U.S. Law, including the requirements of the Office of Foreign Asset Control (OFAC). Some restrictions apply; all requests are subject to approval.


___________________________________________
Member Signature
_______________________
Date

Star One Credit Union use only

Rev: 06/19/2017


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