Account Change Form (Page 2 of 2) in pdf

Account Change Form Page 2

Office Use Only

MSR Name: ______________________

(800) 226-6673

Document Type: Account Change Form

Date processed ____________________

PUBLIX EMPLOYEES FEDERAL CREDIT UNION

UPDATE BENEFICIARY FORM

The Beneficiary(ies) listed below will be added to ALL share accounts listed under your base account number.

The Beneficiary(ies) listed on this form will replace any Beneficiary(ies) you may have previously listed on the account. IF YOU

DO NOT WANT A CURRENT BENEFICIARY TO BE REMOVED, THEY MUST BE LISTED ON THIS FORM.

If not appearing in person, mail to the nearest PEFCU branch office with a photo copy of your identification. Identification

accepted: Valid Driver’s License or State ID. This form will not be processed without proper identification.

NAME: ______________________________ ACCOUNT # __________________________

DATE: __________________________

Beneficiary Full Name

Complete Address

DOB

Social Security No.

Relationship

REQUIRED SIGNATURE(S)

All owners on the account must sign this form.

By Signing this form I agree to the terms and conditions found in the “Important Account Information” Brochure and the Governing Law on

my original Membership application.

Owner signature: __________________________________________ Owner signature: __________________________________________

Rev. 9/15

Account Change Form Page 2