Corporate America Credit Union - Share Draft Adjustment Request

Share Draft Adjustments ONLY should be entered on this form.

RETURNS MUST BE ENTERED IN THE IMAGES/RETURNS/REPORTS SYSTEM

NOTE: Your credit union is responsible for any delays or failure to return items submitted on the Share Draft Adjustment Form.

* - Indicates required field

Credit Union Information

Routing Number

Credit Union Name

CU Fax Number

First Name

Last Name

Email Address

Phone Number

Debit Adjustment Amount

Credit Adjustment Amount

Note: Adjustment Types - Source of Receipt or Non Entry Request Require Debit or Credit Adjustment Dollar Amount.

Listed As

Should Be

Check Number

Clear Date

Trace Number

Clear Date

Trace Number

Adjustment Description

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