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Golden 1 Credit Union P.O. Box 15966 Sacramento, …

3 2 1 1 7 5 2 6 1 Golden 1 Credit Union Box 15966 sacramento , CA 95852-1966 ACH-60 (12-11) STATE OF california CONTROLLER S OFFICE STD. 699 (REV. 12/2011) (Reverse of Employee copy) PLEASE READ THIS INFORMATION CAREFULLY COMPLETION INSTRUCTIONS 1. To enroll in direct Deposit, complete this form as follows: General Instructions Complete Sections A, B and C if you are enrolling for the first time, re-enrolling after cancellation, or changing your existing direct Deposit information. Complete Section A and D only if you are cancelling your enrollment. Specific Instructions Section A (Item 1) Type of Enrollment Action New Complete for new enrollment or re-enrollment after cancellation Change Complete to change type of account, financial institution or branch (routing number), or depositor account number Cancel Complete to cancel your direct Deposit Section B (Item 1) Indicate checking OR savings.

state of california − controller’s office std. 699 (rev. 12/2011) (reverse of employee copy) please read this information carefully completion instructions

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