* - Required Fields
|Type of Account
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.)
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
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
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.