Monthly Statement Info Update Form

Please complete the form below to update the contact list for receiving monthly statements. If you have more than three contacts that need added or removed, please complete additional forms.

Requestor Name

Name of person requesting the change.

Requestor Email

Email of person requesting the change.

Account(s)

Your five-digit account number can be found on your monthly statement. (click +add box, type account number in search. If number is available, email aschultz@cpumf.org)

Add

Contact Update 1 - Name

Contact 1 - Email

Contact 1 - Add/Remove

Monthly Newsletter Addition/Removal

Check this box to request the same action to be completed for the monthly newsletter.

Contact 2- Name

Enter contact name to reveal additional data fields.

Contact 3- Name

Enter contact name to reveal additional data fields.

Additional Notes

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