1. Print a copy of the following Account Application and New Member Questionnaire.
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1 How to Apply 1. Print a copy of the following Account Application and New Member Questionnaire. 2. The following apply to the Trustor, Trustee and any Co-Trustees: If you are applying in person, please be prepared to present an unexpired government issued picture ID (such as a driver s license). If you are mailing the application, you will need to obtain a notarized copy of your ID to submit with your application. If you name a joint owner or convenience person, each must also supply a ID (notarized as applicable). Does your picture ID match your current mailing address? If not, in order to combat identify theft, we will require that you supply at least 2 relevant pieces of mail to your current address containing your name (such as a utility bill, cable bill, etc.). 3. Please complete the New Member Questionnaire for Personal Accounts. This questionnaire helps us to get to know you and to meet our regulatory requirements. 4. View your account disclosures. If you apply by mail or in person, copies of the disclosures will be provided to you in a New Member folder. 5. Write a check (payable to Sussex County Federal Credit Union) or provide cash (if applying in person only) for your initial deposit of at least $5. Either deliver the application to a Branch office or mail it to us at the address shown on the application.
2 Sussex County Federal Credit Union TRUST ACCOUNT APPLICATION PO Box 1800, 1941 Bridgeville Highway Seaford DE Membership Eligibility Who is eligible for membership: Trustor Trustee Beneficiary How is this person eligible? Type of Trust Revocable Living Trust Irrevocable Living Trust Testamentary Trust (Totten) Trustor Information For a testamentary (Totten) account, use the Trustee s name and Social Security/Tax ID Number. For a Living Trust: (1) if irrevocable, use the Trust s Tax ID Number; (2) if revocable, use either the Trustor s Social Security/Tax ID Number or a Trust Tax ID Number. Trustor s Name Social Security/Tax ID Number Name of Trust Trustee Information Social Security/Tax ID Number Driver s Lic. No. Date of Birth PIN Name Home Street Address City State Zip Mailing Address If Different From Home Address Home Phone Work Phone Cell Phone Address Co-Trustee Information Social Security/Tax ID Number Driver s Lic. No. Date of Birth PIN Name Home Street Address City State Zip Mailing Address If Different From Home Address Home Phone Work Phone Cell Phone Address Successor Trustee Information If all of the above Trustees are unable or unwilling serve as Trustees, any on e of the following persons (in the order indicated) may serve as Successor Trustee for purposes of managing the Account. If the 1 st Successor Trustee is unable or unwilling to serve as Trustee, then the 2 nd Successor Trustee may serve as Trustee. 1 st Successor Trustee s Name Social Security/Tax ID Number Address 2 nd Successor Trustee s Name Social Security/Tax ID Number Address Designation of Beneficiary If the Trust is revocable, upon the death of the Trustor, the funds on deposit belong to the Trustor s beneficiaries. Funds will be allocated in equal amounts to all beneficiaries listed unless you instruct us otherwise.
3 As Trustee for the above-named Trustor, I am applying for a Prime Share account and the other services which I have designated below: Checking Savings Club Holiday Club Other Debit Card Audio Response On-line Banking Bill Pay Electronic Statements Overdraft Transfer From Shares I authorize SCFCU, at its discretion, to complete a transaction that may cause an overdraft to my checking or savings account when using my debit card at ATMs, and for everyday merchant purchases. I understand that I will be assessed a service charge. I agree to repay the amount of funds advanced immediately, or as required by the terms of our Overdraft Privilege Program (if applicable). If I do not make this election and I proceed to incur such overdrafts, I understand that SCFCU may terminate my card privileges or close my account. TRUSTEE/MEMBER AGREEMENT This account shall be subject to all applicable Credit Union laws, regulations, practices and customs and the Rules and Regulations of this Credit Union for this type of account, as amended from time to time in the Credit Union s sole discretion. RECEIPT OF A COPY OF OUR DISCLOSURE STATEMENT IS ACKNOWLEDGED. By signing this application, you acknowledge and consent to the following identity confirmation program: We require original, unexpired government-issued picture identification and a taxpayer identification number. For non-u.s. persons we require one or more of the following: (1) A taxpayer identification number; (2) A passport number and country of issuance; (3) An alien identification card number; (4) A number and country of issuance of any other government-issued document evidencing nationality or residence and bearing a photograph or similar safeguard. If you are mailing this application, we require that you submit a notarized copy of your picture identification. We may verify any information provided by you, e.g., your credit report. We may also ask you to provide additional information that we need to verify your identity, and for other purposes related to your membership. Your signature on this application authorizes the Credit Union to keep a copy of any information you provide to establish your identity. SUBSTITUTE W-9 CERTIFICATION Under penalty of perjury, I, as trustee for the trustor named on this form, certify that: (1) The number shown on this form is the trustor s correct Taxpayer Identification Number (TIN); and (2) The trustor is not subject to backup withholding because: (a) the trustor is exempt from backup withholding, or (b) the trustor has not been notified by the Internal Revenue Service (IRS) that the trustor is subject to backup withholding as a result of a failure to report all interest or dividends, or (c) the IRS has notified the Trustor that the trustor is no longer subject to backup withholding; and (3) The trustor is a U.S. person (including a U.S. resident alien). Certification Instructions: You, the trustee, must cross out item 2 above if the trutor has been notified by the IRS that the trustor is currently subject to backup withholding because of under-reporting interest or dividends on the trustor s tax return. The IRS does not require your consent to any provision of this document other than the certifications required to avoid withholding. Trustee s Signature Date Co-Trustee s Signature Date Trustor s Signature Date Trustor s Signature Date FOR CREDIT UNION USE ONLY Date of Membership: Opened/Approved by: Member Verification: Audio Response On-Line BK E-Stmt PIN Setup OD Shares Other Account Numbers(s): Principal: Custodian: ODP Debit Card Issued
4 Instructions for Completing the Account Application Membership Eligibility Either the Trustor, Trustee, or Beneficiary must be eligible for membership. State how you are eligible. See Eligibility for Membership for guidance. Most members are eligible because they either live, work or regularly worship in Sussex County or because they are a family member of an eligible member. Trustee Information Enter all of your personal information. In the PIN section, you should select a secret code (we recommend four or more letters or numbers). This code will be used to identify you when you call us. Co-Trustee Information Each joint owner should enter his/her personal information. Each may also select a PIN. The application accommodates two joint owners. If you want to add additional Co- Trustees, add them on a blank application. Payable on Death/Beneficiary Information Enter your beneficiaries providing as much information as possible so that we can properly identify them. If the Trust is revocable, upon the death of the Trustor, the funds on deposit belong to the Trustor s beneficiaries. Funds will be allocated in equal amounts to all beneficiaries listed unless you instruct us otherwise. Signatures All of the following must sign the application, the Trustor, the Trustee, and any Co- Trustees. Each must sign their own signature.
5 Sussex County FCU New Member Questionnaire Personal Account Please take a moment to answer the following questions. This will enable us to better meet your needs and our responsibilities under the Patriot Act and similar laws. Why have you applied for an account at SCFCU? How did you find out about us? Will this account be used strictly to conduct personal business? Yes No If no, please explain. Will you be making any large cash deposits or withdrawals? Yes No If yes, please briefly describe the nature of these transactions. Thank you for response. Your Signature Date For Internal Use: Member Name: Account #: MSR Copy To BSAO Yes No BSAO Notes:
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Individual Retirement Account (IRA) New Account Application ederated The USA PATRIOT Act requires the Funds to obtain, verify, and record information that identifies each person who opens an account. Failure
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LIMITED LIABILITY COMPANY MEMBERSHIP APPLICATION PROFESSIONAL LIMITED LIABILITY COMPANY MEMBERSHIP APPLICATION Section 1 General Member Information Name of Business: Business Address: Business email: Guarantor
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This IRA form is used for Traditional IRA, Employee Qualified/Profit Sharing/401k Plan, Rollover IRA, Roth IRA and SEP IRA. SECTION 1: Existing IRA Registration IRA DISTRIBUTION FORM Owner s Name (Last,
More information855.550.5090. IMPORTANT:
Cedar Ridge Funds Use this New Account Application to open an individual, joint, UGMA/UTMA, trust, or corporate account. If you have any questions about completing this form, please contact Shareholder
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