Forms and Disclosures

Frequently used forms and disclosures available online in a downloadable .pdf format.

Forms

• Master Account Signature Card Form*
• Payroll Allocation Form*
• ATM Dispute Form*
• Automatic Transfer Request Form*
• Stop Payment on Member Checks Form*
• Online Banking Stop Payment Disclosure*
• Deposit/Transfer Form*
• Overdraft Authorization Form*
• LA County Employee Direct Deposit Form* 
• LACERA Payroll Deduction Form*
• Social Security Direct Deposit Form*
• Beneficiary Designation Form*
• Switch Kit*
• LA County Payroll Deduction Form*
• Domestic Wire Transfer Form*
• International Wire Transfer Form*
• Member Wire Instructions*
• Opt-In Debit* Additional information regarding our Overdraft Privilege program.
• Opt-Out Check*
• Arbitration Opt Out*

Applications

• Consumer Loan Application*

Disclosures

Frequently used documents are now available online in a downloadable .pdf format.

• Account Agreement and Truth-In-Savings Disclosure* (Effective 5/01/19. Addendum added and effective 07/01/20)
• Online Banking, Mobile Banking, & Mobile Deposit Agreement & Disclosure* (Effective 12/01/18. Addendum added & effective 11/01/19)
• Online Account Application ESIGN Consent Disclosure* (Effective 12/01/18)
• Online Loan ESIGN Consent Disclosure* (Effective 02/01/19)
• Electronic Services Disclosure and Agreement* (Effective 12/01/18. Addendum added & effective 11/01/19)
• Visa Benefits – Visa Credit Cards* (Effective 04/01/11)
• VISA Gold, Platinum and Classic Credit Card Disclosure and Agreement* (Effective 05/31/15)
• Visa Share Secured VISA Disclosure* (Effective 05/31/15)
• Stop Payment Disclosure* (Effective 03/02/18)
• eStatements Disclosure*
• Billing Rights Summary*
• Error Resolution for Electronic Transfers*
• Internet Banking Security Notice*
• Notice of Change in Open-End Loan Payment Due Date (Home Equity Lines of Credit Loans(HELOC) and Fixed Rate Personal Lines of Credit)*
• Opt-In Debit* Additional information regarding our Overdraft Privilege program.
• Opt-Out Check*
• Check 21*
• Your Insured Funds*
• Member Conduct Policy*
• Patriot Act*
• Privacy Policy* (Effective 8/2018)
• Text and Voice Alert Disclaimer* (Effective 03/20/18)

Other

• 2020 Annual Calendar*
• 2019 Annual Report*
• Touch Teller Guide*
• Fighting Back Against Identity Theft*
• Check Reorder Form*
• File a complaint with the FBI’s IC3* Report if you feel you have been a victim of an Internet crime
• Quicken® Web Connect, Web Connect Express, QuickBooks and Mint Conversion Instructions*
• Internet Banking Security Notice*
• Money Management Tools*

Fees

• Schedule of Fees and Charges* (Effective 12/01/18)