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Direct Deposit Authorization Change
(Use this form to change your payroll, dividends, royalties and etc.)

Primary Account Holder:


Secondary Account Holder:


Please accept this letter as authorization to change the bank account information for direct deposit in the names of:

------------------------------------------------, payment type is ___________________.

I am aware that some automatic deposits require advance notice of changes. Please consider those notice periods when determining the new effective date.
Effective immediately, the new bank information is as follows:

Friend Bank account number: ___________________.
Bank address: 220 East Lawrence Harris Highway Post Office Box 640 Slocomb, Alabama 36375.
The type of my new bank account is: choose one
Checking __ Savings __ CD __ Money Market __
My new bank routing number is 062102221.
If available, attached is a voided check from my account.
If you have questions, please call me at ____________________. Please send me written confirmation of when the change will be effective.
Thank you for your cooperation.
Sincerely, ______________________

Equal Housing Lendor. Member FDIC. © Copyright 2008 Friend Bank. (334) 886-2367   .