PAM (Personal Account Manager) Sign Up Form

You may use this form to sign up for PAM (Personal Account Manager) and PayIT® Bill Payment Service.

Fill in all the fields, then print the form out, sign it, and mail it to:

Garden State Federal Credit Union
P.O. Box 680
Moorestown, NJ
08057-0680

or fax it to 1-856-235-2904.

Yes, I would like to apply for the services I've checked below. I understand that there is no cost for the PAM (Personal Account Manager) or the PayIT® Bill Payment.
  PAM (Personal Account Manager) (No Cost)
  PayIT Bill Payer Service (No Cost)
I have a Touch Tone Phone
 
Your Information
Select One:
Mr.  Mrs.  Ms.
Social Security #:
First Name:
M.I.:
Last Name:
Address:
Home Phone:
City:
Work Phone:
State:
Zip:
Mother's Maiden Name:

(for security identification verification)
E-mail:
       
Joint Account Owner Information
First Name:
M.I.:
Last Name:
 
   
General Account Information (Refer to your enrollment letter for details on this section.)
Primary Account #:
 
       
Bill Payment Account(s)
Joint Account:
Account #(Checking Only):
Personal Account:
Account #(Checking Only):

Authorization

I/We desire to subscribe to the services and authorize the Credit Union, and any third party acting on our behalf, to serve as our/my agent in processing payments to targeted merchants and/or transfer to and from targeted Accounts pursuant our/my payment and/or transfer instructions. I/We authorize the Credit Union to post such payment and/or transfer to our/my designated Account(s). I/We understand the Credit Union may not make certain payments and/or transfers if sufficient funds are not available in our/my designated Account. This authorization is in force until revoked by you/us or the Credit Union in writing, and is subject to the Service Terms and Conditions (a current copy is to be furnished to me/us with our/my Welcome Kit) as amended from time to time.

Bill payments should be made by me/us at least five business days prior to their due date. For fees and charges, see the Credit Union's Rate & Fee Schedule.

Your Signature:
_______________________________
Date:
________
Joint Owner's Signature:
_______________________________
(Required when joint accounts are specified)
Date:
________

Please call the office (1-800-713-2274) for any further information.