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 Name

Routing Number

CU Fax Number

First Name

Last Name

Phone

Ext

Debit Adjustment Amount

Credit Adjustment Amount

Select Adjustment Type

Check Number

Listed As

Should Be

Clear Date

Trace Number

Clear Date (Paid Twice)

Trace Number (Paid Twice)

Description