Membership

Member Information

Name

First Name

Last Name

Social Security #

Birthdate

Email

Address

Address Line 1

Address Line 2

City

State

ZIP Code

Mother's Maiden Name

Home Phone

No. Years

Issuing State*

Driver's License No.*

Employer's Name & Address

Business Phone

Previous Address

Address Line 1

Address Line 2

City

State

ZIP Code

The Type of Services You Are Requesting

PLEASE NOTE: FOR MEMBER AND EACH JOINT OWNER, APPLICATIONS MUST BE ACCOMPANIED BY COPY OF VALID DRIVER'S LICENSE, OR PHOTO ID. SIGNATURE(S) NOT WITNESSED BY AN EMPLOYEE MUST BE NOTARIZED.

DESIGNATION OF JOINT OWNER ACCOUNT (1)

The following three (3) sections need only be completed if you are planning to have Joint Owner(s)

Name

First Name

Last Name

Social Security #

Birthdate

Email

Address

Address Line 1

Address Line 2

City

State

ZIP Code

No. Years

Home Phone

Business Phone

Mother's Maiden Name

Driver's License No.*

Issuing State*

Previous Address

Address Line 1

Address Line 2

City

State

ZIP Code

Employer's Name

Employer's Address

DESIGNATION OF JOINT OWNER ACCOUNT (2)

Name

First Name

Last Name

Social Security #

Birthdate

Email

Address

Address Line 1

Address Line 2

City

State

ZIP Code

No. Years

Home Phone

Business Phone

Mother's Maiden Name

Driver's License No.*

Issuing State*

Previous Address

Address Line 1

Address Line 2

City

State

ZIP Code

Employer's Name

Employer's Address

DESIGNATION OF JOINT OWNER ACCOUNT (3)

Name

First Name

Last Name

Social Security #

Birthdate

Email

Address

Address Line 1

Address Line 2

City

State

ZIP Code

No. Years

Home Phone

Business Phone

Mother's Maiden Name

Driver's License No.*

Issuing State*

Previous Address

Address Line 1

Address Line 2

City

State

ZIP Code

Employer's Name

Employer's Address

SIGNATURE(S)

SIGNATURE(S) INCORPORATED BY REFERENCE: EACH OF THE PROVISIONS SET FORTH ABOVE AND BELOW ARE PART OF YOUR TOTAL ACCESS MEMBER SERVICE PLAN. BEFORE YOU SIGN BELOW BE SURE YOU HAVE READ AND UNDERSTAND THE MASTER SHARE ACCOUNT AGREEMENT FOR EACH SERVICE YOU HAVE REQUESTED

By signing below, I certify, in accordance with IRS W-9 instructions provided by the Credit Union and under penalties of perjury, that the Social Security number (SSN) / Taxpayer identification number (TIN) shown is my / the correct identification number and that I am NOT, unless designated below, subject to backup withholding because I have not been notified that I am subject to backup withholding as a result of a failure to report all dividend or interest, or because the IRS has notified me that I am no longer subject to backup withholding. The Internal Revenue Service does not require your consent to any provision of this document other than the certification required to avoid backup withholding.

I am a U.S. person (including a U.S. resident alien.) I am subject to backup withholding Exempt I am not a United States citizen or resident (complete W-8 form)

Signatures

BY SIGNING BELOW, YOU AGREE TO BE BOUND BY THE TERMS SHOWN ABOVE, FURTHER BELOW, AND IN THE MASTER SHARE AGREEMENT.

Signature

Date

Signature

Date

Signature

Date

DESIGNATION OF BENEFICIARY(IES)

Payable on Death Beneficiary

Name

First Name

Last Name

D.O.B.

Address

Address Line 1

Address Line 2

City

State

ZIP Code

TRANSFER TO MINORS CUSTODIAL ACCOUNTS

Name of Custodian (1)

First Name

Last Name

Social Security #

Birthdate

Email

Address

Address Line 1

Address Line 2

City

State

ZIP Code

No. Years

Home Phone

Business Phone

Mother's Maiden Name

Driver's License No.

Issuing State

Previous Address*

Address Line 1

Address Line 2

City

State

ZIP Code

Name of Custodian (2)

First Name

Last Name

Social Security #

Birthdate

Email

Address

Address Line 1

Address Line 2

City

State

ZIP Code

No. Years

Home Phone

Business Phone

Mother's Maiden Name

Driver's License No.

Issuing State

Previous Address*

Address Line 1

Address Line 2

City

State

ZIP Code

CONTINUED FROM ABOVE - READ CAREFULLY BEFORE SIGNING THIS AGREEMENT ABOVE

You hereby make application for membership in TUCOEMAS FEDERAL CREDIT UNION and agree to conform with the Credit Union's bylaws and amendments, laws, policies and applicable regulations and to subscribe for at least one (1) share.

By signing above, you affirm that all the member information you have provided is complete and correct to the best of your knowledge, and agree to furnish such other information as we may request from time to time. In considering your request for any financial service, we may request and use reports from your employer, former employer, creditor(s) and / or outside reporting agencies or services. We may also ask for such reports in connection with the renewal or continuation of a financial service you may request. You also authorize us to answer questions and requests from others, concerning you and the status of any of your accounts with us. At your request we will tell you whether we asked for a report from a credit reporting service, and if so, the name and address of the agency or agencies. You understand that it is a crime punishable by fine or imprisonment or both under state and federal laws to knowingly make any false statements concerning any fact an insured financial institution relies on in extending credit to you. If there is any change in your name or address, or if any financially significant change occurs after you have applied for any service, you agree to notify us immediately, and maintain consistent address changes on all Tucoemas products.

Information from your share savings membership application may be used within the Credit Union or, if the Credit Union owns or controls a credit union service organization ('CUSO'), provided to that organization.

As required by law, you are hereby notified that a negative report reflecting on your obligations to us may be submitted to an outside reporting agency if you fail to fulfill the terms of your obligations.

You certify and acknowledge that the signature(s) above and on pages 1 and 3 are acurate and belong to the joint owner(s) indicated above. You understand and agree that we will rely upon this document as a true copy of the Member Services Application and as the sole determinant of facsimile signatures.

By signing this agreement above, you authorize the use of a facsimile signature or endorsement by designation on the Signature Card or in a separate membership application. If you have so authorized the use of a facsimile signature or endorsement device or have otherwise used such a device, the Credit Union may honor or accept for deposit any check or other signed instruction which bears or appears to bear your facsimile signature or endorsement even if it was made by an unauthorized person or with a counterfeit facsimile device. Therefore, you should maintain close control over your facsimile signature or endorsement device and promptly review your statements and canceled checks for unauthorize use of this device. We reserve the right not to accept signature reproduced by a fax machine or any other facsimile method or device of signature reproduction.

You must be a signer on the account to make a transaction of any kind. Each Joint Owner must sign above and on the Signature Card. The Social Security Number / Taxpayer Identification Number (TIN) and certification all pertain to the member whose signature appears first on the Member Services signature card.

Transfer to Minor Custodial Accounts: Pursuant to California Probate Code 3913, a custodial account is for a minor person. It provides that an adult may make an irrevocable gift to any minor. The funds in such an account are owned by and in the name of the minor. However, an adult custodian for the account must be listed. The custodian may or may not be the donor. There may be only one custodian and one minor on each account. To be eligible to open an account, the minor or custodian must be eligible to join the credit union. See the Truth in Savings Disclosure Supplement (TIS Supplement) and Master Share Account Agreement for the specific terms for this account.

By signing above, you acknowledge that you have received, read and agree to be bound by the terms of the Master Share Account Agreement and each other Agreement contained herein for each member service you have requested. Each such term is incorporated herein by reference. You acknowledge your receipt of money, goods, or services under the applicable Agreement each time you use a service you have requested and each time you accept funds we place in any of your Credit Union accounts or otherwise deliver to you on your behalf.

Further, the foregoing shall apply with regard to any member service you request in the future pursuant to this Agreement.

You may now review the application for changes or "Reset" to start over. When you have completed the applicaiton, please print the application for submission to a Membership Services Representative at a branch near you. If you prefer to mail the completed application, a notarized signature is required on the Membership Signature Card. You may access the Signature Card from the link below.

Click the button below only if you are planning to mail in the completed application with your notarized signature.