Account Change Request Form

Use this form to request updates to your account details. Please complete all required fields, and our team will process your request as soon as possible.

Submit a Change Request

Businessman signing important documents at office desk.

Step 1 of 13

Name(Required)

First Middle Last

Please list the account numbers that need changing:(Required)

Change Type(s)(Required)

Check all that apply:

Add / Close Account

Add / Remove Owner

Address / Phone / Email Change

Name Change

Beneficiary Change (excludes trust accounts)

Add / Remove Service(s)

Mail Handling Change

Other

Other(Required)

Additional Information

ACCOUNT OWNERSHIP CHANGES

Please select which of the following actions you wish to take:(Required)

Name/change account owner

Name/change agent

Add owner

*Remove owner

Owner Removal Acknowledgment(Required)

I/we agree.(Required)

*By choosing the “Remove Owner” option above, you have chosen to remove the selected owner(s) from the account(s) designated on this form. You understand that removal of a Multiple Party Account Owner requires consent of all account owners, and you will hold the credit union harmless for actions regarding account access. The removed account owner(s) relinquishes ownership interest including any membership share in the account(s) set forth above. This relinquishment does not affect your obligation of any loan account(s).

SHARE / SAVINGS ACCOUNTS

Check all that apply:

Share (savings)

Club

Certificate (CDs)

Student

CHECKING ACCOUNTS

Check all that apply:

Free checking

Fresh Start

Student

Money market

Owner Information

Name

First Last

Date of Birth

Month

Day

Year

Social Security Number

Physical Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

Mailing Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

Home phone

Cell phone

Enter Email Confirm Email

Employer

New employer phone number:

Business Phone

Ext.

Occupation

Driver's license state of issue

Driver's license number

Grant Rights of Survivorship?

Would you like to make another ownership change?

Yes

Secondary Owner Information

Name

First Last

Date of Birth

Month

Day

Year

Social Security Number

Physical Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

Mailing Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

Home phone

Cell phone

Enter Email Confirm Email

Employer

New employer phone number

Business Phone

Ext.

Occupation

Driver's license state of issue

Driver's license number

Grant Rights of Survivorship?

ADDRESS / CONTACT INFO / EMPLOYER CHANGE

Which of the following are you looking to change?

Address(es)

Phone number(s)

Employer information

New physical address

Street Address Address Line 2 City State ZIP Code

Home phone

Cell phone

New email address

Enter Email Confirm Email

Have you retired from this occupation?

Yes

Occupation

New employer name

New employer address

Street Address Address Line 2 City State ZIP Code

New employer's business phone

Ext.

New security / verification code, or mother's maiden name

NAME CHANGE

Name

First Middle Last

Driver's license number

PAYABLE ON DEATH BENEFICIARIES(Required)

By signing below, each party designates the person(s) named below as Payable on Death Beneficiaries on the accounts indicated. You agree to save, defend and hold The Focus Federal Credit Union harmless from any liability in connection with this POD designation. Designation not available on Multiple Party Accounts without Right of Survivorship.

I agree

Primary

Will you be adding or removing a Beneficiary?

Add

Remove

ACCOUNT TYPE(S)

SHARE / SAVINGS ACCOUNTS

Share (savings)

Club

Certificate (CDs)

Student

CHECKING ACCOUNTS

Free checking

Fresh Start

Student

Money market

Beneficiary Information

Name

First Middle Last

Social Security Number

Relationship

Physical address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

Date of birth

Month

Day

Year

Phone number

Add or remove another Beneficiary?

Yes

Would you like to name or edit a Contingent Beneficiary?

Yes

Second Beneficiary

Will you be adding or removing this Beneficiary?

Add

Remove

ACCOUNT TYPE(S)

SHARE / SAVINGS ACCOUNTS

Share (savings)

Club

Certificate (CDs)

Student

CHECKING ACCOUNTS

Free checking

Fresh Start

Student

Money market

Name

First Middle Last

Social Security Number

Relationship

Physical address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

Date of birth

Month

Day

Year

Phone number

CONTINGENT BENEFICIARY

Will you be adding or removing a Beneficiary?

Add

Remove

ACCOUNT TYPE(S)

SHARE / SAVINGS ACCOUNTS

Share (savings)

Club

Certificate (CDs)

Student

CHECKING ACCOUNTS

Free checking

Fresh Start

Student

Money market

Name

First Middle Last

Social Security Number

Relationship

Physical address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

Date of birth

Month

Day

Year

Phone number

Add or remove another Contingent?

Yes

SECOND CONTINGENT BENEFICIARY

Will you be adding or removing a Beneficiary?

Add

Remove

ACCOUNT TYPE(S)

SHARE / SAVINGS ACCOUNTS

Share (savings)

Club

Certificate (CDs)

Student

CHECKING ACCOUNTS

Free checking

Fresh Start

Student

Money market

Name

First Middle Last

Social Security Number

Relationship

Physical address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

Date of birth

Month

Day

Year

Phone number

Do you want to add a service?(Required)

Yes

Select the services you'd like to add(Required)

Payroll Deduction

Share / Savings

Share Draft / Checking

ATM / Check Card

Student Checking

Over-Draft Protection

Bounce Safe / Courtesy Pay

Home Banking

Fresh Start Checking

Club Account

Touchtone Teller

Share Certificate

Line of Credit

Direct Deposit

Money Market

Bill Pay

Other

Other(Required)

Additional Information

Do you want to remove a service?(Required)

Yes

Select the services you'd like to remove(Required)

Payroll Deduction

Share / Savings

Share Draft / Checking

ATM / Check Card

Student Checking

Over-Draft Protection

Bounce Safe / Courtesy Pay

Home Banking

Fresh Start Checking

Club Account

Touchtone Teller

Share Certificate

Line of Credit

Direct Deposit

Money Market

Bill Pay

Other

Other(Required)

Additional Information

CHANGE MAIL HANDLING

Hold all mail

Remove mail hold

Effective date

Month

Day

Year

AUTHORIZATION

By signing below, I/we agree that the changes on this form amend the previously signed Membership Document and are subject to the terms and conditions of the Membership Disclosure, Schedule of Fees and Charges, and to any amendment the credit union makes from time to time which are incorporated herein.

Signature(Required)

Your Name
Your Name
Your Name

Date(Required)

Month

Day

Year

Type(Required)

Primary

Joint Owner

Agent

Is another signature required?(Required)

Yes

Signature(Required)

Your Name
Your Name
Your Name

Date(Required)

Month

Day

Year

Type(Required)

Primary

Joint Owner

Agent

Is another signature required? (2)(Required)

Yes

Signature(Required)

Your Name
Your Name
Your Name

Date(Required)

Month

Day

Year

Type(Required)

Primary

Joint Owner

Agent

Is another signature required? (3)(Required)

Yes

Signature(Required)

Your Name
Your Name
Your Name

Date(Required)

Month

Day

Year

Type(Required)

Primary

Joint Owner

Agent

Consent

I/We, the above members of The Focus Federal Credit Union have elected to opt out of my personal information being shared with FFCU business partners.