The Information You Want . . . When You Want It!
Click on any of the forms below to "Print Your Own."
Not sure which form is right for you?  Give us a call at (502) 629-3716.

NEW: On-Line Bill Pay − PayIT

To enroll in PayIT, please print our AnyTime Access Request Form, check the PayIT box at the top and fill in the information and your signature below.  Fax or mail the form back to the Credit Union. (Fax: 502-629-3715)

Other Bill Pay forms and disclosures:  PayIT Bill Payment Agreement and Disclosure  and  PayIT Instructions and FAQ

When we receive the form, we will set up your access and send you an e-mail to let you know you can start using bill pay. 

Membership Forms

Customer Identification
When you open an account, we will ask for your name, address, date of birth, and other information that will allow us to identify you. We may also ask to see your driver’s license and other identifying documents.

If the address on your ID does not match the address on your application, we will ask you why they do not match and we will need additional verification of your current address.

Thank you for joining!

Automatic Deposit Form 
One of the great benefits of Credit Union Membership is Automatic Deposit.  Any regular recurring check can be automatically deposited to your Share or Share Draft (Checking) Account, including Payroll, Social Security, Pension, etc.

Use this form to start or maintain your Automatic Deposit.  Easy 1-2-3 directions are included on the form or call us at (502) 629-3716 for more information.

Application for Share Draft (Checking) Account 
Use this form to open a Share Draft (Checking) Account with your Credit Union.  You may also want to pick out Checks and get your automatic Automatic Deposit started.

Wire Out Transfer Form
Use this form to initiate a transfer of funds from your Credit Union account to an account with another financial institution.

Friends & Family  
Refer a New Member and get a chance to win $100!
If you work in a hospital or healthcare organization, your co-workers are eligible to join.  Members of your immediate family are also eligible to join.

Refer a New Member to our Credit Union and you get entered in a quarterly drawing for $100.00.  To be entered in the drawing print THIS FORM.  Fill it out and ask the person you refer to attach it to their Membership Application form. Drawings will be held the end of each quarter.  You do not need to be present to win.  Members of the Board of Directors and members of the Credit Union Staff (and their families) are not eligible to enter.

Membership Forms are available by clicking HERE.

CUMoney VISA Reloadable Prepaid Debit Card To apply for a CUMoney VISA Prepaid Debit Card, please complete the Anytime Access form below.  See CUMoney FAQ and Card Agreement at right.			CUMoney Frequently Asked Questions and Prepaid Debit Card Agreement If you are applying for a CUMoney Prepaid Debit Card, please print this disclosure to go along with your AnyTime Access Request Form.
AnyTime Access Form    Use this form to request access to your account information through $tatLINE Audio Response or VirtualBranch, internet home banking.  Access is free and is available 24/7.  See EFT Agreement at right. You can also use this form to request and ATM or VISA Debit Card and our NEW On-Line Bill Pay service − PayIT or CUMoney Prepaid VISA Card.  See PayIT Agreement, Disclosures, Instructions and FAQ at right.			Electronic Funds Transfer Agreement  If you are applying for an ATM Card or a VISA Debit Card, please print this disclosure to go along with your Anytime Access Request Form. PayIT Bill Pay Agreement & Disclosures If you are applying for PayIT internet bill pay, please print the disclosure to go along with your Anytime Access Request Form. PayIT Bill Pay Instructions and FAQ View or print the document to help you navagate our bill pay service.

Loan Forms 

VISA Balance Transfer Request Form 
Use this form to transfer a balance from another high interest rate Credit Card to your low, fixed rate Louisville Medical Center Federal Credit Union VISA Credit Card Account.

Line-of-Credit Advance Request 
If you already have a pre-approved Line of Credit with us, you can use this form, rather than a full loan application, to request an advance.  Just indicate the amount you want advanced and any changes in employment, income, or debts and payments since your last application.

Christmas Club Forms    

Christmas Club Accounts may be opened only from mid October through Christmas Eve each year.

Christmas Club Application
Use this form to open a NEW Christmas Club Account for next year.

Christmas Club Change or Stop Form
Use this form to CHANGE or STOP an existing Christmas Club Account for next year.

Lost/Stolen Form

Lost/Stolen Card Report - PIN Request Form (combination form)

FIRST, if your ATM, Debit or Credit Card has been lost or stolen,
CALL IMMEDIATELY TO REPORT IT:

To report a lost or stolen Credit Union Visa Credit card, call 1-800-991-4964.
To report a lost or stolen Credit Union ATM or Debit card, call 1-800-472-3272.

AFTER you have called, please follow up by completing this form and forwarding it to the Credit Union as soon as possible.

Use this combination form to report a Lost or Stolen ATM Card, Debit Card or VISA Credit Card.  You may also use this form to request a replacement card and/or to request re-issue of your PIN (personal identification number).

VISA Forms  
  

Balance Transfer Request Form
Use this form to transfer a balance from another high interest rate Credit Card to your low, fixed rate Louisville Medical Center Federal Credit Union VISA Credit Card Account.

VISA Credit Card Agreement
This is a copy of our VISA Credit Card Disclosure and Agreement.  The VISA Account Opening Disclosure below is also a part of this agreement.

VISA Account Opening Disclosure
This addendum is part of your VISA Credit Card Agreement.  If you are opening a new VISA Credit Card account with us, please review this form. 

Other Forms
For any other forms you may need, please call us at 502-629-3716 or e-mail us at ItsEasy@LMedFCU.org and we can mail or fax the forms you need.