Corporate America Credit Union - Share Draft Adjustment Request

Share Draft Adjustments ONLY should be entered on this form.

RETURNS MUST BE ENTERED ON THE RETURNS FORM

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

Prove you're not a robot*