Membership & New Account Application
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- Blaise Osborne
- 10 years ago
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1 Complete and return this form to any branch office OR mail all pages to: Texans Credit Union, Attn: Member Account Services, PO Box , Richardson, TX Include $25 minimum deposit to open share/savings account and/or $50 minimum deposit to open checking account. Membership & New Account Application Two forms of identification required when opening an account. For more info on identification requirements: Visit Open an Account on our website ( or call Member Services at or Member Information and Ownership Member Number 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 your name, address, date of birth, and other information that will allow us to identify you. Member Social Security/Tax Identification Number Address Home Phone Work Phone Cell Phone of Birth Phone Verification Physical Address City State Zip Mailing Address (if different) City State Zip Primary ID State Secondary ID Type Membership Qualification Job Title / Description Employer Previous Financial Institution Special Ownership of Accounts to be opened: TUTMA Estate Minor 2. New Accounts Share (Savings) Travel Share Texans Money Market Performance Money Market Other: My Texans Checking My Texans Interest Checking Other: With the exception of IRA accounts, all accounts selected will be jointly owned if this application lists any Joint Owner(s). 3. Joint Owners Primary ID State Secondary ID Type SSN/TIN Address /City/State/Zip of Birth Primary ID State Secondary ID Type SSN/TIN Address/City/State/Zip of Birth Primary ID State Secondary ID Type SSN/TIN Address/City/State/Zip of Birth 4. Payable on Death By signing on Page 2, each party designates the person(s) named below as Payable on Death Payee(s) on the account indicated. I agree to save, defend and hold Texans Credit Union harmless from any liability in connection with this POD designation. of Birth SSN/TIN Relationship to Member of Birth SSN/TIN Relationship to Member of Birth SSN/TIN Relationship to Member Texans Credit Union Membership & New Account Application Page 1 TCU-1114 (Rev. 1/15)
2 5. ATM / Debit Card Request (Cardholder must be member or joint owner and sign below) 6. Certification of Taxpayer Identification Number and Backup Withholding THE INTERNAL REVENUE SERVICE DOES NOT REQUIRE YOUR CONSENT TO ANY PROVISION OF THIS DOCUMENT OTHER THAN THE CERTIFICATIONS REQUIRED TO AVOID BACKUP WITHHOLDING. W-9 CERTIFICATION - IF DEPOSITOR IS U.S. CITIZEN OR RESIDENT ALIEN UNDER PENALTIES OF PERJURY: I certify (1) that the number shown on this form is my correct taxpayer identification number (or I am waiting for a number to be issued to me), and (2) I am not subject to backup withholding because: (a) I am exempt from back-up withholding, or (b) I have not been notified by the Internal revenue Service (IRS) that I am subject to backup withholding as a result of a failure to report all interest or dividends, or (c) the IRS has notified me that I am no longer subject to backup withholding and (3) I am a U.S. person (including a U.S. resident alien. Certification Instructions. You must cross out item 2 above if you have been notified by the IRS that you are currently subject to backup withholding because you have failed to report all interest and dividends on your tax return. W-8 CERTIFICATION - IF DEPOSITOR IS FOREIGN PERSON OR ENTITY: Certification is provided on a separate document. ACCOUNT OWNERSHIP (APPLICABLE IF JOINT OWNERSHIP IS DESIGNATED): The owners intend to and do hereby create a joint tenancy with rights of survivorship; and specifically agree to the terms set forth in the Membership Agreement including but not limited to the Credit Union s rights to pay or transfer any deposits by the order of any owner, to accept a pledge of all sums deposited now or in the future from any owner, and to enforce any legal or contractual lien rights as to any owner s obligations. 7. Authorizations By signing below, you make application for membership in Texans Credit Union and agree to subscribe to one share. In relation to my/our account, and by signature(s), I/we authorize the Credit Union to check my/our credit and employment history at any time, to request and use reports regarding same, and to answer questions about the Credit Union s experience with me. Each person signing below acknowledges that he/she has read and agrees to the terms set forth in the Credit Union Deposit Agreement which is incorporated into and made part of this application. Member Signature Notary Requirement (Not Required for Existing Members or Existing Joint Owners) Sworn and subscribed before me by: On the day of, 20 Sworn and subscribed before me by: On the day of, 20 Sworn and subscribed before me by: On the day of, 20 Sworn and subscribed before me by: On the day of, 20 _ For Credit Union Use Only Third-Party Verification: Override Authorization Dept/Branch Information Signature: Branch : Member: Approved Denied Joint 1: Approved Denied Employee : Joint 2: Approved Denied Joint 3: Approved Denied : Auditor: Audited: Share (Savings) Travel Share Checking Other List Account Numbers Opened Texans MM Performance MM Other Other Texans Credit Union Membership & New Account Application Page 2 TCU-1114 (Rev. 1/15)
3 Authorization to Setup Overdraft Protection Member : Member #: Account #: Overdraft protection for your checking account is available from two of the following: Share (savings), money market, and/or a Texans Line of Credit. Transfers and withdrawals from savings and money market accounts are limited to six (6) per month including overdraft protection transfers. An insufficient funds fee* will be assessed on your checking account when the savings or money market account has exceeded the six (6) transaction limit. Please reference to Texans current Fee Schedule. Credit approval is required for a Texans Line of Credit. A joint owner on your checking account, who is not a joint owner on your savings, money market, and/or a co-borrower on your Texans Line of Credit, will have access to your savings, money market, and/or Texans Line of Credit. Other checking accounts are excluded as an overdraft option. *A fee may be charged for overdraft protection as set forth in the Fee Schedule. If sufficient funds are not available, then any item presented for payment will be returned to the payee due to insufficient funds and a charge will be made to your account in such amounts as we may establish from time to time. List up to two overdraft account numbers below: Note: Regulation D only allows a total of six (6) preauthorized, automatic transfers or telephone transfers per month from savings accounts. Transactions that do not count toward the six (6) limit are withdrawals and transfers made in person with a teller, withdrawals and transfers made at an ATM, withdrawals and transfers made by mail, and automatic Texans loan payments. I wish to use my savings, money market or Line of Credit account as overdraft protection for my checking account. I understand that transactions in excess of six (6) per month from my savings or money market account caused by an overdraft protection transfer may result in an overdraft fee as shown in the current Fee Schedule. Member Signature: : I do not wish to set up overdraft protection at this time. Member Signature: : For Texans Use Only: Processed By: Audited By: : : 777 E. Campbell Road Richardson, TX REV 1/2015
4 Courtesy Pay Opt In/Out Form REG E Texans Wants to Protect You! We want to help our members manage their finances responsibily. We also understand that unforeseen circumstances or expenses can possibily leave you with insufficient funds in your checking account. To protect you from additional merchant fees, potential embarrassment and possible damage to your credit history, we offer two options for your checking account: Overdraft Protection and Courtesy Pay. Overdraft Protection vs. Courtesy Pay Overdraft Protection is a service where money is transferred from a designated savings, money market or line of credit to cover any transactions that would otherwise overdraw your checking account. Think of this as your first line of defense. When used, a fee of $5.00 per transaction is assessed. Courtesy Pay is a service that protects you when there is not enough money in your designated overdraft account and Texans pays a transaction on your behalf. Courtesy Pay covers checks you write and automatic payments (such as bill payments) and is standard with our Texans checking accounts. You receive this service automatically after your account has been open for 30 days. Courtesy Pay can also cover your every day debit card and ATM transactions. This option is not automatica you have to tell us you want this coverage by opting in (see bottom of page or accompanying form). Benefits of Courtesy Pay Coverage If your account is low on funds and you need to make a purchase or cover an emergecy expense, your transaction will be declined without coverage. Our Courtesy Pay coverage offers: Convenience even if you are low on funds, your transaction will be covered on the spot Peace of mind vital coverage in urgent circumstances, such as unexpected car repairs Privacy you are saved the potential embarrassment of a declined transaction Courtesy Pay is a great back-up option when paired with our Overdraft Protection. If you don t have an alternative account to designate for overdrafts or you lack enough funds in the designated account to cover a transaction, Courtesy Pay can help you avoid declined purchases. Think of this as your back-up plan to cover an unexpected expense, which is especially helpful when making an important purchase. Courtesy Pay is a Discretionary Service Discretionary means that your ATM transactions and debit card purchases are not guaranteed to go through and Texans reserves the right not to pay a transaction. We typically do not pay overdrafts if your account is not in good standing, you are not making regular deposits, you have had excessive overdrafts or your account has not been open for at least 30 days. Cost for Courtesy Pay There is no cost to enroll in Courtesy Pay coverage and there is never a fee unless you use it! You are only charged a fee if you overdraw your account and Courtesy Pay is used. Each time Courtesy Pay is used, a fee of $35 per transaction is assessed. Opting In for Courtesy Pay Debit Card / ATM Transaction Coverage Call us at or , visit a branch or visit us online at TexansCU.org (Services > Convenience > Courtesy Pay). You may also send the completed form to: Texans Credit Union Attn: Member Account Support P O Box Richardson, TX Fax: Questions? For additional information on our Overdraft Protection and Courtesy Pay services, please contact our e-branch at or or visit your local branch. We want to make sure your account is protected with the best overdraft coverage that fits you. Page 1
5 Courtesy Pay Opt In/Out Form REG E What You Need to Know about Overdrafts and Overdraft Fees An overdraft occurs when you do not have enough money in your account to cover a transaction, but we pay it anyway. We can cover your overdrafts in two different ways: 1. We have Courtesy Pay that comes with your account. 2. We also offer Overdraft Protection, such as a link to a savings, money market account or line of credit which may be less expensive than Courtesy Pay. To learn more, ask us about these plans. What is the Courtesy Pay coverage that comes with my account? We authorize and pay overdrafts (via Courtesy Pay), for the following types of transactions: Checks and other transactions made using your checking account number Automatic bill payments deducted from your account We do not authorize and pay overdrafts on consumer accounts for the following types of transactions unless you ask us to: ATM transactions Everyday debit card transactions We use Courtesy Pay at our discretion, which means we do not guarantee that we will always authorize and pay any type of transaction. If we do not authorize the use of Courtesy Pay for an overdraft, your transaction will be declined or returned. What fees will I be charged if Texans Credit Union pays Checks, ACH or Bill Pay through Courtesy Pay? Under our Courtesy Pay coverage: A $35 Courtesy Pay fee is assessed every time we pay a transaction. If we do not pay a transaction, the NSF fee of $35 applies. There is no limit on the total fees we can charge you for overdrawing your account. What if I want Texans Credit Union to authorize and Courtesy Pay overdrafts on my ATM and everyday debit card transactions? If you want Texans to authorize and Courtesy Pay overdrafts on your ATM and everyday debit card transactions, or would like to change your authorization at a later date, call or You may also complete the form below and present it to your local branch or fax it to us at Call: Click: Mail: Texans Credit Union Attn: Member Account Support P O Box Richardson, TX (We will record your selection within two business days of receipt.) Fax: Checking Acct No: (One account per form) Member No: Please check only one box below: [ ] I want Texans to authorize and pay overdrafts on my ATM and everyday debit card transactions. [ ] I do not want Texans to authorize and pay overdrafts on my ATM and everyday debit card transactions Signature Print For Branch Use Only Accepted By : Emp # Branch # For MAS Use Only Received By : Emp # Dept. # Keyed By : Emp # Dept. # For e-branch Use Only Employee : Emp # : Spoke to: Mode of Verification: Page 2
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GEORGIA REGENTS UNIVERSITY OFFICE OF STUDENT & MULTICULTURAL AFFAIRS MEDICAL COLLEGE of GEORIGA GB 3300 SUPPLEMENTAL INSTRUCTION PROGRAM SIP LEADERS SIGN-UP FORM Instructions: Please complete and have
