Statement Copy Request

Please follow these instructions:
  1. To request a copy of your statement, you may either call our Member Service Center or completely fill out this form.
  2. Print the form by pressing the print button.
  3. Sign the form.
  4. Fax this form to 305-270-6588 or bring the form to one of our branches. To confirm receipt of the fax, you may call 305-270-5251.
The form below may be used to order copies of your statement(s). You may either order just one statement copy or a range of statement copies.
General Information




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Check Information

The first month request is free. The cost of each additional month is $2.00 per month.

Single Statement    OR     Range of Statements

Year:


Mail    Pick up at:   



Savings Checking

Please sign this form. By signing this form, I agree to pay for this service.


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Signature

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