Smoke signals., May 15, 2008, Page 11, Image 11

MAY 15, 2008
Smoke Signals 11
YOU ARE NOT REQUIRED TO DO ANYTHING UNLESS
YOU HAVE CHANGES TO YOUR DEDUCTIONS OR
WOULD LIKE TO SIGN UP FOR, CANCEL OR CHANGE
YOUR DIRECT DEPOSIT INFORMATION.
Have you updated your beneficiary designation? Have you checked your beneficiary designation for your
CTGR Member Trust & Adult Savings Plan account recently? If not, you may find that your designated
beneficiary is not who or what you think it should be, especially if you have divorced, remarried or had
children since your account was established. It is important to keep your beneficiary designations current to
ensure that benefits are paid promptly and according to your wishes. If you need to change your beneficiary
because of marriage, divorce, adoption of a child or a birth or death in your family, please contact Hollie
Mercier at at 503-879-2490 or 1-800-422-0232, ext. 2490, for a copy of the beneficiary change form.
The Confederated Tribes of the Grand Ronde Community of Oregon
do REDW Benefits, LLC
Per Capita Administrator for the Confederated Tribes of the Grand Ronde Community of Oregon
PO Box 93656
Albuquerque, NM 87199-3656
FAX 505-998-3442 or 505-998-3333
e-mail benefitsredw.com
Direct Deposit Authorization Agreement
for Quarterly Per Capita Deposits
AUTHORIZATIONS:
I hereby authorize and request The Confederated Tribes of the Grand Ronde (CTGR) to initiate deposit entries and the
FINANCIAL INSTITUTION named below to accept the deposit to my account indicated below. Further, I authorize
CTGR to initiate withdrawal entries and adjustments for any deposit entries made in error to my account no later than
ten (10) business days after the date of the original deposit entry .
This authority is to remain in full force and effect until CTGR and financial INSTITUTION receive written notification
from me of its termination in such time and in such manner as to afford CTGR and FINANCIAL INSTITUTION a
reasonable opportunity to act on it.
MEMBER INFORMATION:
Member Enrollment No.: Member's Name:
Member's Financial Institution: Financial Institution's 9 Digit Transit Routing Number
Member's Checking or Savings Account No.: Circle Type of Account:
CHECKING SAVINGS
Member's Signature:
Date:
IN CASE OF QUESTIONS, PLEASE PROVIDE THE FOLLOWING PHONE NUMBERS
Member Phone Number
Financial Institution Phone Number
Jo Omltlt
1294 Anytrt Court
Anyclty, AA 12345
Pwy to Mt ontmr of
3?
1134
Bank Anywtw
P1294974 123494744123 .1234
T
Number
Account CtMCli
For checking account, attach voided check (not a deposit slip).
If depositing to a savini account, ask your bank
to give you the RoutlngT ransit Number for your account.
It kn 7 always the same as the number on a savings deposit slip,
Thh will Inxure that you are paid correctly.
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