CHANGE OF ADDRESS REQUEST FORM

Name: _________________________________________________

Account Number: ________________________________________

I request a change of address with the credit union on all of my accounts

to be effective as of ____/____/____.

Old Address: ___________________________________________

___________________________________________

New Address: ___________________________________________

___________________________________________

My New Phone Number is: _________________________________

____ Please change my address linked to my DEBIT CARD.

Member signature: ________________________________________

Today’s Date: ____________________________________________

Please mail or fax to the following:

Tyler City Employees Credit Union

819 N. Spring St.

Tyler, TX 75702

Fax: (903) 593-8781