HomeTown Credit Union Address Change Form
Please print this form, fill it out and fax to 507/451-9358 or
mail to 2400 West Bridge Street, Owatonna, MN 55060


Name:_____________________________________________

Member Number(s):__________________________________

*New Address: Phone Numbers:
___________________________________ Home:___________________________________
___________________________________ Work:___________________________________
___________________________________ Cell:_____________________________________
___________________________________

Email Address
:____________________________________________________________________
Sign Here______________________________________ Date:____________
*If residential address and mailing address are different, please include both. Your address change request will become effective when the Credit Union receives this completed form and verifies the authenticity of your signature.

Internal Use Only:

Employee Initials __________________________

VISA Dr _________________________________

Date Received _____________________________

Checking ________________________________
Member Signature Verified Loans ___________________________________
VISA Cr ___________________________________ IRAs ____________________________________