Fraud Form

If any fraudulent transaction (i.e. Check, ATM, Debit, or ACH/Electronic transaction) cleared your account, please submit the Fraud Form.

You can download the form to submit your request!

Fraud Form (Adobe Acrobat .pdf format)

To open this Application, you will need the Adobe Acrobat Reader.

We’ll need the following information:

  1. Primary member’s Name
  2. Address, Email; and Home, Work and Cell phone number
  3. Member Account Number
  4. ATM and/or Debit Card Number
  5. Share Draft ID Number (13-digit number on the bottom of your checks)
  6. ATM/Debit Card Number (if applicable)
  7. Names on the Account
  8. Check Number (if applicable)
  9. Transaction Date
  10. Transaction Amount
  11. Payee
  12. Endorsed by (if applicable)
  13. ACH Routing Number (if applicable)
  14. ACH Company ID (if applicable)
  15. ACH Trace Number (if applicable)
  16. ACH Individual ID (if applicable)
  17. Name on ACH
  18. Signature (Mandatory)

Fraud Form (Adobe Acrobat .pdf format)

To open this Application, you will need the Adobe Acrobat Reader.

Please, contact our Member Services Officer at 404-525-0619 ext. 219 for more details.

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