PAM (Personal Account Manager) Sign Up Form

You may use this form to sign up for PAM (Personal Account Manager) and PayITŪ Bill Payment Service.

Fill in all the fields, then print the form out, sign it, and mail it to:

NJ Community Federal Credit Union
P.O. Box 680
Moorestown, NJ

or fax it to 1-856-235-2904.

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Yes, I would like to apply for the services I've checked below. I understand that there is no cost for the Internet Service or the PayIT Bill Payment Option.

Internet Service (No Cost)

PayIT Bill Payer Service (No Cost)

I have a Touch Tone Phone

Social Security #

Your Information  
Select One:
Mr.   Mrs.   Ms.
First Name:
Middle Initial:
Last Name:
Home Phone:
Work Phone:
Mother's Maiden Name:

(for security identification verification)
Joint Account Owner Information
First Name:
Last Name:
General Account Information (Refer to your enrollment letter for details on this section.)
Primary Account # (PAN):
Bill Payment Account(s)
Joint Account Account # (Checking Only):
Personal Account Account # (Checking Only):


I/We desire to subscribe to the services and authorize the Credit Union, and any third party acting on our behalf, to serve as our/my agent in processing payments to targeted merchants and/or transfer to and from targeted Accounts pursuant our/my payment and/or transfer instructions. I/We authorize the Credit Union to post such payment and/or transfer to our/my designated Account(s). I/We understand the Credit Union may not make certain payments and/or transfers if sufficient funds are not available in our/my designated Account. This authorization is in force until revoked by you/us or the Credit Union in writing, and is subject to the Service Terms and Conditions (a current copy is to be furnished to me/us with our/my Welcome Kit) as amended from time to time.

Bill payments should be made by me/us at least five business days prior to their due date. For fees and charges, see the Credit Union's Rate & Fee Schedule.

Your Signature _______________________________ Date ________

Joint Owner's Signature ___________________________ Date ________
(Required when joint accounts are specified)

Please call the office (1-800-361-9322) for any further information.


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