CU Action Fund Contribution Form

MM slash DD slash YYYY
Contact Name(Required)
To ensure that funds are collected and expended in compliance with federal law and regulation, please check the box for the category that most closely corresponds to the organization providing the funds. If funds transferred fall into more than one category, please complete a separate transfer form for each category.

Category One

State chartered credit unions that are affiliated with/members of CrossState. Credit union service organizations that are majority-owned by CrossState affiliated non-federally chartered credit unions.

Category Two

Federally chartered credit unions that are affiliated with/members of CrossState. Credit union Service Organizations that are majority-owned by a federally chartered credit union(s).
Category Selection

Suggested fair share investment based on credit union asset size:

  • Over $1B in Assets – $15,000
  • $750M-$1B in Assets – $10,000
  • $250M – $750M in Assets – $5,000
  • Below $250M in Assets – $2,500
Please make your check/share draft payable to Credit Union Action Fund and send to:
CrossState Credit Union Association 4309 North Front Street Harrisburg, PA 17110

Questions about the CU Action Fund may be directed to Christina Mihalik, at cmihalik@crossstate.org.

Please note: Entities that currently file an IRS Form 990 should include the amount of their donation in the aggregate amount reported in Part 1-A of Schedule C to Form 990. Payments to CrossState for the Credit Union Action Fund are not tax deductible.