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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

  Print this form 

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