DHSCU Forms

Information Request Forms:

 Electronic Information Permission Request
This form allows DHS Credit Union to fax or email, at your request, personal information regarding your account when you request us to do so.

 Payroll Deduction
This form authorizes your Employer to deduct funds from your salary and deposit these funds to DHS Credit Union for each payroll period.

Direct Deposit

This form authorizes your Employer to direct deposit your entire salary to DHS Credit Union for each payroll period.

TN Education Lottery Direct Deposit and/or    Payroll Deduction

This form authorizes your Employer to direct deposit or payroll deduct your salary to DHS Credit Union for each payroll period.

 Change of Address Request
Notify DHS Credit Union of your new address, new phone number, email address, name change or any other important account information so you may continue to receive the personal service you have come to love.  If you do not notify DHSCU of your changes, it will result in a $5.00 Return Mail Fee per piece.

Request to Close Account

The easy to fill in form needs to be completed, printed off, signed and either faxed or mailed to the credit union should you wish to close your account.

Transfer Funds & Wire Request Form

Member to Member Funds Transfers

Pro-active fraud prevention are the key words for implementing the Member to Member funds Transfer.  Full name and account information is needed when completing this form.  Fill the form out online, print, sign and deliver to DHSCU.

Wire Request Form

All information must be filled out by the member for requesting DHS Credit Union to wire funds from your account to a third party.  Fill the form out online, print, sign, and then fax to DHSCU.

ACH & Debit Card Forms:

 Statement Under Penalty of Perjury
To request DHSCU to return an unauthorized ACH on your DHS Credit Union account.
This is a legal document stating you have followed all required steps in stopping any pre-arranged agreement made by you the consumer with a company. Call prior to completing this form for the proper instructions. Incomplete or improper information will void any request indemnifying DHS Credit Union. Terms and conditions do apply.

 One Time ACH Transfer Request
To make a one time transfer.
This form allows DHS Credit Union to make a one time transfer from a different financial institution to your DHSCU Share Savings or Share Draft Checking.

ACH Account Transfer Request

To make a scheduled reoccurring transfer

This form allows DHS Credit Union to make a scheduled reoccurring transfer from a different financial institution to your DHSCU Share Savings, Share Draft Checking or Club Account.

ACH Loan Payment Request

To make a scheduled reoccurring loan payment

This form allows DHS Credit Union to make a scheduled reoccurring loan payment from a different financial institution to your DHSCU Loan Accounts.

Debit Card Dispute Affidavit

To file a dispute made on your account with our Debit Card.  Directions for filling out the form - Failing to follow directions will delay your dispute. This form allows DHS Credit Union to mediate disputes transacted with your MasterCard Debit Card.  Detailed instructions must be followed to insure a timely review.

Terms and conditions do apply.

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Application Forms:

Membership Application
The first step in becoming a DHSCU member!

Loan Application
To be completed online, printed out and faxed, mailed, or personally delivered to our office.

Check Order Request

Must be used in ordering your first box of checks.  Complete online, print then faxed, mailed or personally delivered to our office.  To view the full line of checks see the Liberty Icon our Online Services page.

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DHS Credit Union
400 Deaderick St., Street Level, Nashville, TN 37248-1982
(615) 313-5585, (800) 235-0403, Fax: (615) 741-5007