Date* CTR Prepared for: Host Credit Union name* Member Number* Member Account #* Fax # of Host CU* Shared Branch (Your Info): Credit Union Name* Branch Street Address* City, State, Zip* CTR Prepared by: Employee Name, Title* Employee Phone #* Employee Fax #* Items sent: CTR Form & ID Completed CTR attached & transmitted Unable to transmit, missing information Copy of Member’s ID included Attachment Add files Cancel Delete Comments: 1600 characters left Submit Drop files here to upload
