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Assignment of Savings Account (United States)

This is a form transfers a savings account. The form provided here is simply a sample of what the actual form looks like.


For value received, I, __________(1)___________,

Of ________(2)___________,

transfer and assign to ______(3)________,

of _______(4)_____________, as assignee,

savings account No. _____(5)_____,

in my name with ___________(6)__________, and all moneys due or to become due thereunder.

I authorize _______(7)_____________ to pay over to assignee this sum out of moneys deposited in my name in the above-mentioned account.

I warrant that I have made no prior transfer or assignment of any part of the account assigned hereby and that

the balance thereof is now at least ______(8)_______ Dollars ($________).

I have delivered to assignee herewith the savings passbook issued in connection with this account, and I authorize assignee to ask for, demand, collect, and give a receipt for money in the assigned savings account, without any previous demand or notice. I agree to do whatever assignee may reasonably require to assure payment to assignee, to the extent hereby assigned, of the money in the account.

Dated __________(9)___________, ____(10)_.


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