P.O. BOX 3398, BATON ROUGE, LA 70821-3398 • PHONE: 800-522-2748 or 225-342-5055 • FAX: 800-297-2717 or 225-342-9135 • WWW.LACAPFCU.ORG
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Member Signature: _________________________________________________ Date: _________________
If you choose to opt-out for Debit Card Overdraft Privilege, La Cap will not approve your Debit Card
transactions if there are not sufficient funds available in your account to cover the transaction. Your
transaction will be denied.
If you choose to opt-in for Debit Card Overdraft Privilege La Cap may, at our discretion, approve your
one-time debit card transactions even though your account balance may not currently show sufficient
funds available to cover the transaction.
We pay overdrafts at our discretion, which means we do not guarantee that we will always authorize and
pay any type of transaction. If we do not authorize and pay an overdraft, your transaction will be
La Cap charges our standard fee of $23 each time we pay an overdraft. There is no limit to the amount
of fees that may be charged for overdrawing your account.
Please complete this Authorization Form in order to participate in our Debit Card
Overdraft Privilege for checking accounts.
Debit Card Overdraft Privilege
Opt In / Opt Out Authorization
Debit Card Overdraft Privilege Opt In / Opt Out Authorization - 08/10
Teller: _________ Date: _________ Confirmation Provided: _________ Added: _________ Removed: _________
OPT IN for La Cap to authorize and pay one-time debit card transactions.
OPT OUT for La Cap to authorize and pay one-time debit card transactions.
4 easy ways to return form:
Mail: P.O. Box 3398, Baton Rouge, LA 70821
Online: at www.lacapfcu.org
Visit: Drop off at your local La Cap branch
Fax: (225) 342-9135