LAPEER COUNTY SCHOOL EMPLOYEES CREDIT UNION

PAYROLL DEDUCTION FORM 

Last Name____________________________First_____________________Initial__________

Address_____________________________________________________________________

City_______________________Zip__________________Phone________________________

School Name: CHATFIELD

Your Classification________________________________

PLEASE DEDUCT FROM EACH PAY $_________________________

To apply as follows:

 Shares 00________________________

Shares 61______________________

Shares 62______________________

Christmas Club 69_________________

Drafts 91________________________

 

Signature______________________________ Date______________ Acct #_________