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Membership Application

* - Required Fields

Type of Account  

Please tell us how you are eligible to join First U.S. Community Credit Union by clicking on the appropriate selection.




 



How did you hear about First U.S. Community Credit Union?





If you were referred by someone, please tell us their name so that we can thank them.


Primary Owner of Account
E-Mail Address  
Employer Name  
* Gross Annual Income    
* Last Name   M.I.
* First Name    
* SSN#    
* Birth Date    
* Drivers License #   * State  
* Mother's Maiden Name    
* Home Phone    
Work Phone  
* Street Address    
* City    
* State    
* Zip Code    

If there will be a joint owner on this account please check this box.
Yes, This will be a joint account. (If this box is checked, please supply joint owner information.)

Co Applicant
E-Mail Address  
Employer Name  
* Gross Annual Income    
* Last Name   M.I.
* First Name    
* SSN#    
* Birth Date    
* Drivers License #   * State  
* Mother's Maiden Name    
* Home Phone    
Work Phone  
* Street Address    
* City    
* State    
* Zip Code    

Comments      

Important Information About Procedures For Opening A New Account

To help the 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 who opens an account.

What this means for you: When you open an account, we will ask for your name, address, date of birth, and other information that will allow us to identify you. We may also ask to see your driver's license or other identifying documents.

By submitting this application you certify that the above statements are true and complete. You also agree to be bound by the terms and conditions of the membership disclosure for your account. If there is more than one person applying, each of you understands and agrees that each person will be individually and jointly liable for this account.

I/We hereby authorize First U.S. Community Credit Union to receive and exchange credit, income, and employment information and permit the Credit Uniont to verify this information from whichever source it deems necessary and may, now and in the future, provide others with information regarding my credit history with you, to the extent permitted by law

I/We certify under penalty of perjury that the taxpayer ID/Social Security Number(s) given to First U.S. Community Credit Uniont on this application is/are correct. I/We have never received notice from the Internal Revenue Service for the underreporting of dividends or interest. I/We am/are not now obligated to have dividends or interest withheld.

Disclosure (You must click the disclosure link to activate the "submit" button in order to continue the application process.)
*Borrower: I agree to these terms  
*Co-Borrower: I agree to these terms  
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