DIRECT DEPOSIT FORM
ACCOUNT NUMBER_________________________________________ DATE___________________________
NAME_____________________________________________________ SSN___________________________
SSMOK Employees Federal Credit Union ROUTING #
TO EMPLOYER:_____________________________________________
PAYROLL NUMBER:   
I hereby authorize you to deduct the following from my pay until further notice, and transmit to the above named Credit Union.
____MONTHLY ____SEMIMONTHLY ____BIWEEKLY ____WEEKLY
____NEW ____CHANGE ____STOP ____REALLOCATE
TOTAL DEDUCTION
EFFECTIVE DATE
CREDIT UNION EMPLOYEE
EMPLOYEE SIGNATURE______________________________________


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SSMOK Employees FCU
1000 North Lee #3214
Oklahoma City, OK 73102
Fax: 405-272-6379