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ACH Form

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Authorization for Preauthorized Loan Payments And Share Deposit to GPCU

We authorize GOLDEN PLAINS CREDIT UNION to initiate withdrawals to my/our account at the DEPOSITORY (identified below) for the purpose of accomplishing the following preauthorized payments:

I have the right to receive notice at least 10 days in advance of the payment date of any payment of a varying amount.

Payment Frequency
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Depository Information

Account Type


My/Our account will remain subject to its individual terms and conditions, which are not modified by this authorization.

I/We understand that this authorization will remain in full force and effect until the termination date or unless sooner termination by GPCU, at its option, or unless termination by me/us by giving written notification of such termination to GPCU at its address, such notification to be received by GPCU at least Ten (10) days prior to the next date on the loan or deposit. Nothing herein contained shall bind or require GPCU to accept payment on the underlying loan by use of an EFT.

Account Type

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