Overdraft Authorization

* Indicates Required Fields

• Date *
• Member Number *
• Name *

Disclosures and important information

Overdraft Privilege Program Summary

Items Paid Using the Overdraft Privilege Program

• Checks and other debits cashed with a Teller
• Automatic bill payments (ACH Items)
• Checks written on your share draft account

E-Service Items Requiring a Signed Authorization Form

Alternatives to Opting In via this Authorization Form

• Member Authorization
  I wish to have Overdraft Privilege services extended to me on ATM withdrawals and debit card transactions. By submitting this form, I understand that Space Age Credit Union will authorize these transactions to my share draft account through the Overdraft Privilege Program. Additionally, I understand that I may receive a $33.00 fee per item paid ($10.00 fee for items of $10.00 or less paid) utilizing the service. If I wish to have Overdraft Privilege services discontinued in the future, I may do so at any time.