Cancellation Form

Any account owner may cancel SELCCU Online service. To cancel this service, complete this form below or submit a letter in writing, including your signature and date. Any cancellation shall not affect any of your existing liability to us.

Name: ___________________________________________________________________________

Account Number: __________________________________________________________________

Home Address: ___________________________________________________________________

City: ____________________________________________ State: _________ Zip: _____________

Home Phone: _____________________________ Work Phone: ____________________________

Email Address: ___________________________________________________________________

Check one:

___	Authorization to cancel E-Statements only.
		(We will resume mailing your statements to your address of record.)

___	Authorization to cancel SELCCU Online.
		(Which will cancel only your User ID access to SELCCU Online.)





__________________________________		____________
Signature		Date

School Employees Lorain County Credit Union, Inc.
340 Griswold Rd., Elyria OH 44035
www.selccu.org - memberservices@selccu.org - 440/324-3400