Northwest Resource Federal Credit Union

		Please Close My Account

Full Name
Address
City		State Zip
Home Phone

Please close my checking account at:
Financial Institution
Checking Account #

Please check one:
Mail the balance of my checking account to my home address above
Send the balance of my checking account to be deposited at Northwest Resource Federal Credit Union (see address below)

Northwest Resource Federal Credit Union 221 NW Second Avenue, Portland, OR 97209		Credit Union Account Number (6 digits)

I authorize the closure of my checking account.

Effective Date __________________________________

Signature_______________________________________

Joint Signature__________________________________

Today's Date ___________________________________

Please print and sign this completed form and
send to the financial institution that has your current checking account.

Northwest Resource FCU • PO Box 2788 • Portland, OR 97208