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Wells Fargo | Authorization for Automatic Transfer (Payment)

LDF9170/594562 (Rev 16 - 01/22)Page 1 of 2 Authorization for Automatic Transfer (Payment)Do not use this form for Personal Lines of Credit on Bank ID 448 (FDR)New Automatic TransferChange Existing TransferCancel Existing TransferTransfer From:CheckingSavingsRouting Transit Number (9-digit number on the bottom left of your check)Account Number (to the right of the bank routing number on your check)Customer Name(s)Institution NameTransfer To:Installment LoanLine of CreditAccount Number Customer Name(s) Transfer Information/Payment OptionsOther financial institutions may assess excess activity fees on savings accounts.

Authorization for Automatic Transfer (Payment) Do not use this form for Personal Lines of Credit on Bank ID 448 (FDR) ... payable to a third party. A total of six transfers and/or withdrawals in a month including: those listed above, pre-authorized or automatic transfers (including overdraft protection and payments to third parties), and ...

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