 |
| |
| Primary Owner |
|
| |
| Name |
|
Social Security # (Tax ID#) |
|
| Home Address |
|
| City |
|
State |
Zip |
|
Date of Birth
(mm/dd/yyyy) |
|
Home Phone
(xxx-xxx-xxxx) |
|
| Mother's Maiden Name |
|
E-mail |
|
| If joining through family member, please enter their name and relationship |
|
Employed By
(include location) |
|
Work Phone
(xxx-xxx-xxxx) |
|
| |
| Joint Owner |
|
| |
| Name |
|
Social Security # |
|
| Home Address |
|
| City |
|
State |
Zip |
|
| Date of Birth |
|
Home Phone |
|
| Work Phone |
|
E-mail |
|
| |
| Beneficiary |
|
| |
| Name |
|
Social Security # |
|
| Home Address |
|
| City |
|
State |
Zip |
|
| |
| |
|
| |
| Under penalties of perjury, I certify 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
- I am not subject to backup withholding either because 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 the IRS has notified me that I am no longer subject to backup withholding
(does not apply to real estate transactions, mortgage interest paid, the
acquisition or abandonment of secured property, contributions to an individual
retirement account (IRA), and payments other than interest and dividends.)
|
I hereby make application for membership in the credit union named below, and agree to conform
to its bylaws and amendments thereof, copies of which have been made available to me, and to
subscribe for at least one (1) share. If Life Savings Insurance is carried in connection with my
account, I agree, in consideration of the credit union carrying such insurance, that any designation
or change of beneficiary made by me shall only be binding upon the credit union, if I have filed
with the credit union prior to my death, such designation or change of beneficiary, in writing,
signed by me, on the form supplied by the credit union; and, in the absence of so filing a
designation or change of beneficiary, I agree on behalf of myself, my heirs, etc., to indemnify
and save harmless the credit union from all loss or damage by reason of the payment of the proceeds
of such insurance to such person as the credit union records show to be entitled thereto.
The Internal Revenue Service does not require your consent to any provision of this document other
than the certifications required to avoid backup withholding.
JOINT SHARE ACCOUNT AGREEMENT (*NOT TRANSFERABLE)
SAKS FIFTH AVENUE ENTERPRISES FEDERAL CREDIT UNION is hereby authorized to recognize any of the
signatures subscribed in the payment of funds or the transaction of any business for this account.
The joint owners of this account hereby agree with each other and with said credit union that all
sums now paid in on shares, or heretofore or hereafter paid in on shares by any or all of said
joint owners to their credit as such joint owners with all accumulations thereon, are and shall be
owned by them jointly, with right of survivorship and be subject to the withdrawal or receipt of
any of them, and payment to any of them or the survivor or survivors shall be valid and discharge
said credit union from any liability for such payment. The joint owners also agree to the terms
and conditions of the account as established by the credit union from time to time.
Any or all of said joint owners may pledge all or any part of the shares in this account as
collateral security to a loan or loans from the credit union.
The right or authority of the credit union under this agreement shall not be changed or terminated
by said owners, or any of them except by written notice to said credit union which shall not affect
transactions theretofore made.
|
| |
|
|
| |
| We will begin processing this request immediately after receiving it via e-mail.
A form requesting your signature(s), your initial deposit of at least $100 and a copy of a valid ID
will be forwarded to you soon to complete the membership application process. Thank you.
|
