Address Change Request Form

If you have had a change in address, phone number or e-mail address, please print, complete and sign this form.

Please bring this to one of our locations so we may update your information. You may also mail to 1120 W 17th Street, Tulsa OK 74107 or fax 918-582-7588

Member Name	Member #

Physical Address	Mailing Address (if different)
Street:	Street:

City, State & zip:	City, State & zip:
Contact Information
Home:	Cell:
Work:	Alt:
Email
List of Joint Owners That Changes may Apply to
Name:	Phone:
Name:	Phone:
Name:	Phone:
Name:	Phone:
Please check if you have an active ATM or Debit card.

Signature:__________________________________________ Date: _______/_________/__________

Office Use:

____updated TransFund if ATM/Debit card
____updated joint owners w/ corrected information
____check for returned mail

Signature:____________________________ Date: _____/_____/______ Branch: ________________________

Download PDF

EFT DATE 3/28/16