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Forms

Note: These documents are in PDF format and require Adobe Acrobat Reader to view.
If you don't have this software, you may download it free.

Change of Address form
Use this form to request a change of address on your account. Simply complete the form and return it in person, by mail or by fax (See form for return address and fax number).

Visa Debit/Credit Card Fraud
F&A is committed to protecting you and your personal information. If you discover fraudulent use of your credit or debit card, call us to report it at 800-222-1226.

Visa Debit/Credit Card Dispute form
If you need to dispute a charge done with your F&A debit or credit card, please review the attached letter and complete the form to send to us.

ACH (Automated Clearing House) information and form
Click here to learn more about ACH and to access a form. This feature is used to easily move funds between financial institutions.

ACH Stop Payment
Use this form to request a stop payment of an ACH debit or electronic funds transfer. With this form you may also reinstate payments by canceling a previous request to stop a payment. Simply complete the form and return it by mail, by fax or in person.

ACH Fraud form (Do not use if fraud is on a card)
F&A is committed to protecting you and your personal information. If for any reason you should discover a fraudulent debit or electronic funds transfer, fill out this form. You may initially fax it to us but we will require the original to complete the processing of your claim.

Stop Payment on a Member's Check 
Use this form to request a stop payment on a member's check.

Application and Agreement for Minor's Coogan Account form
Click here to access an application for the Minor's Coogan Account. These accounts deal with placing money in trust for minors. Fill out the form on-line, print, sign and deliver to your credit union. This application must have original signatures.

Application and Agreement for Trust Account form
Click here to access this guide & application. Fill out the form on-line, print, sign and deliver to your credit union. This application must have original signatures.

Authorization for Share and Loan Payment Transfers form
Sign up for automatic transfers to any share or loan you have with F&A. You may also transfer to other members, organizations or fire stations that hold accounts with F&A. Fill out the form on-line, print, sign, and fax or mail it to your credit union.

Balance Transfer Request form *This form is not a fillable form.
Use this form to transfer credit card balances from other Financial Institutions.

Direct Deposit Authorization form (For LA County Fire Employees Only)
To set up your LA County Fire Department automatic payroll posting for the 15th and 30th of each month click here. Fill out the form, print, sign, and deliver to F&A FCU. The credit union must receive your information first and we will then forward your request to the county Auditing Department.

Did you know beginning April 16th, 2018 LA County now has an Employee Online Direct Authorization eForm available. Please contact LA County for more information.

LA County Payroll Deduction Card 

LACERA Direct Deposit Authorization form 

LACERA Payroll Deduction form

Servicemember Civil Relief Act form 

Visa Credit Card Authorized User Request form 
If you would like to let someone use your Visa Credit card account with out having to apply for the card, fill-out this form and send it in with any other required documents. Your Authorized User Visa Credit card will be delivered to you with in 10 business days from the day we receive your request.

VISA Stop Payment
Use this form to request a stop payment of a scheduled or preauthorized payment of service or a merchant to your F&A Visa Credit Card or Visa Check Card. With this form you may also reinstate payments by canceling a previous request to stop a payment. Simply complete the form and return it by mail, by fax or in person.

Certificate of Authority form (For LA County Fire Station Accounts Only)
This document must be filled out by all signers on a loan for a fire station loan. Fill out the form, print, sign, and fax or mail it to your credit union.

Membership Application Fillable form
Fillable form with the applicable Deposit Account Agreement and Truth-in-Savings Disclosure attached.  

Membership Signature Card Instructions form
Instructions to fill out a membership account signature card for a new member.

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