ContractMembership Agreement • January 19th, 2012
Important Information About Opening a New Account. To help our government fight the funding of terrorism and money laundering activities, federal law requires all financial institutions to obtain, verify, and record information that identifies each person when opening a new account. What does this mean for you? When you open a new account, we will ask your name, address, date of birth, and other information that will help us to identify you. Wemay also ask to see some type of positive identification. MEMBER/OWNER INFORMATION Member No. Designate the ownership of the accounts and responsibility for the services requested.Individual Joint Account with Survivorship Member/Owner Name: SSN/TIN: Street: ID Type (Driver's Lic.): City/State/Zip: ID Number (License No.): Home Phone: Listed Unlisted ID Issuing State: ID Issuing Date: Work Phone: ID Exp. Date: Date of Birth: Cell Phone: Password: E-Mail: Membership Eligibility: Employer: I am a U.S. Citizen I am a citizen of the following count