Bill Payer Merchant Request Form

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Bill Payer Authorization & Merchant Request Form

This form is to add a Bill Payer Merchant if the merchant is not already listed in SCU-Online Bill Payer

Complete, sign, and mail this Merchant Request Form to:

Sharefax Credit Union, Inc.

Attn: Add Merchant Form

1147 Old St Rt 74

Batavia, OH 45103

Call or visit your Credit Union Location and request a Merchant Request Form
Email your credit union and have an Merchant Request Form sent to you.

Merchant Information

Merchant Name

Merchant Suite/Dept #:

Merchant Street Address

Merchant City

Merchant State

Merchant Zip

Merchant Phone

Your Account Information

Account Number with Merchant

Sharefax Account Number

Suffix to Charge

Day of Month* to Charge

*Must be at least five (5) business days prior to due date.

Bill Amt.

Is payment amount the same each month?

It is the responsibility of the Member to initiate recurring payments once the Merchant/Bill has been added.
Sharefax Credit Union, Inc. is not liable for charges incurred for non-receipt of payment due to insufficient funds or delay in delivery by the U.S. Post Office.
There is NO FEE for this service!

Email Address

(To be notified, via e-mail, your form has been processed)

Full Name

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Your accounts are
insured up to $250,000.

Links Disclaimer: Sharefax Credit Union has provided links to Internet sites maintained by third parties. Sharefax does not operate or control in any respect any information, products or services on these third-party sites. Important Reminder: We will never initiate a phone call, email, or a text asking you to update, validate, or provide us with your personal information. If you receive a questionable e-mail requesting personal information about your accounts that appears to be from Sharefax Credit Union, please contact us at (800) 733-1728 or (513) 753-2440.