MEMBERSHIP ACCOUNT AGREEMENT

You hereby apply for membership in the credit union and agree to conform to the bylaws and any amendments of the credit union, the terms and conditions of the share account and to pay the minimum deposit amount. You also agree to pay any charges or fees which may be required or assessed under such bylaws. Any account opened in more than one name shall be a joint account with rights of survivorship. If you have established a joint account, both owners agree to the terms and conditions of the share account. Please fill out our Membership form then print the form and send it by U. S. Postal mail or drop off at our office. This form cannot be submitted electronically.

Membership Application

Thank you for your interest in Tri County Credit Union. Please fill out the following information, read the disclosure and submit. We are providing the opportunity for you to print out on your local printer the following form. We choose not to risk accepting this information through the unsecured use of e-mail. Please use one of the following methods for submitting this application: US Mail, Fax or you may drop your application off at our Credit Union. Should you require assistance, please contact us.

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.

** NOTE ** Should your copy of this application look different than the one displayed on your screen, please disregard. By providing us with legible information requested, we will be able to process your request. Return To The Home Page

Membership Information
I qualify for membership through my: employer family.
If by family, please provide

family-member's name:

Primary Member

First Name	Gender: Male Female
Middle Initial	Date of Birth / /
Last Name
Address
City State Zip -
Home Phone
Work Phone
Driver's License	State Issued
Social Security Number
Email
Employer

Joint Owner

First Name	Gender: Male Female
Middle Initial	Date of Birth / /
Last Name
Address
City State Zip -
Home Phone
Work Phone
Driver's License	State Issued
Social Security Number
Email
Employer

I am interested in opening: Check all that apply

Direct Deposit	IRA Account
Share Savings	Christmas Club Account
Share Draft Checking	Vacation Club Account
ATM Card	Payroll Deductions
MAC MasterMoney Check Card	Visa Credit Card

This application is subject to approval by the Credit Union. By submitting this application, you authorize the Credit Union to verify credit and employment by any necessary means, including request for a credit report by a credit reporting agency.

______________________________

Signature of applicant

Please print this application form, sign and mail it to us, bring it in to our office, or FAX it.

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