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ONLINE BANKING Login New User

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Page 1

Disclosures

In this Signature Card, “I,” “ME,” and “MY” mean each and every person who signs below. “YOU” and “YOUR” mean F&A Federal Credit Union. By signing below, I agree to the terms and conditions of this Signature Card and to the terms and conditions of the Deposit Account Agreement and Truth-In-Savings Disclosure. If I am currently not a member, I hereby certify that I am within your field of membership, make application for membership with you and agree to conform to your bylaws and any amendments thereto. I have received a copy of Deposit Account Agreement and Truth-In-Savings Disclosure. I authorize you to make any investigation deemed necessary, including a credit check or employment verification. At the time I open my Account, I authorize you to obtain my credit report to determine my eligibility for additional credit opportunities you may offer to me. I authorize you to give information concerning your experiences with me to others. I agree that you may retain this Signature Card and any other information you may receive. I understand and agree that this Signature Card shall only govern the Account(s) set forth above. I will execute additional Signature Card(s) to open other Account(s) with you.

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 me: When I open an account, you will ask for my name, address, date of birth, and other information that will allow you to identify me. You may also ask to see my driver’s license or other identifying documents and an additional questionnaire and documentation may be required.
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You must agree to the disclosures to proceed!
By clicking on the “I agree” button, you consent to the electronic delivery to you by us of any and all account Disclosures and Agreements, and any other subsequent disclosure of information related to the accounts (“Disclosure”) by using your electronic signature. You consent to conduct business electronically regarding membership in F&A Federal Credit Union and the opening of various accounts within that membership.
Page 2

Membership Eligibility

Please note: All membership eligibility is subject to verification. View eligibility requirements.
Your Eligibility*
You must select one
Please indicate your eligible city of employment. If you do not see you city listed, please contact Member Services at 800-222-1226.
Invalid Input
If you are eligible through a relative, you must provide either the referring member's account number or their name and phone number for verification purposes. Which method would you prefer to use?
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Please enter a valid member number
Please enter a relative's name
Please enter a phone number
Type of Membership*
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If you are applying for a minor account, you must have an adult as a joint owner.
Page 3

Primary Applicant

Please enter your last name
Please enter your first name
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Please enter your suffix (Sr, Jr, III, etc.)
Please enter your mother's maiden name
Please enter your email address
Please enter your address
Enter your city
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Please enter your zip code
Is your mailing address different than above?
You must agree to the disclosures to proceed!
Please enter you mailing address
Please enter your city
Invalid Input
Please enter your zip code
Please enter your date of birth
Please enter your home phone
Please enter your cell phone
Please enter your work phone
Please enter your driver's license
Invalid Input
Please enter the expiration date
Please enter your social security number
Please enter your employer name
Please enter your income
Please enter your occupation
Rent or Own
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Subject to backup withholding?
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If selecting No, I certify that I am not subject to backup withholding because: (a) I am exempt from backup 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. citizen or other U.S. person; and (4) I am exempt from FATCA reporting.
Page 4

Joint Applicant

Please enter joint's last name
Invalid Input
Please enter your middle name
Please enter your joint's suffix (Sr, Jr, III, etc.)
Please enter your join's mother's maiden name
Please enter valid email address
Invalid Input
Plese enter you joint's city
Invalid Input
Please enter a valid zip code
Is your mailing address different than above?
You must agree to the disclosures to proceed!
Please enter your joint's mailing address
Invalid Input
Invalid Input
Invalid Input
Invalid Input
Invalid Input
Please enter joint's cell phone number
Please enter joint's work phone number
Invalid Input
Invalid Input
Invalid Input
Please enter the joint's social security number
Please enter joint's employer
Please enter joint's income
Please enter joint's occupation
Rent or Own*
Invalid Input
Would you like to add a second joint account holder?
Invalid Input
Page 5

Second Joint Applicant

Please enter your second joint's last name
Please enter your second joint's first name
Please enter your second joint's middle name
Please enter your second joint's suffix (Sr, Jr, III, etc.)
Please enter second joint's mother's maiden name
Please enter second joint's email address
Please enter second joint's street address
Please enter second joint's city
Invalid Input
Please enter second joint's zip code
Is your mailing address different than above?
You must agree to the disclosures to proceed!
Please enter second joint's mailing address
Please enter second joint's city
Invalid Input
Please enter second joint's zip code
Please enter second joint's date of birth
Please enter second joint's home phone
Please enter second joint's cell phone
Please enter second joint's work phone
Please enter second joint's driver's license number
Invalid Input
Please enter a valid expiration date
Please enter second joint's social security number
Please enter second joint's employer
Please enter second joint's income
Please enter second joint's occupation
Rent or Own*
Invalid Input
Would you like to add a third joint account holder?
Invalid Input
Page 6

Third Joint Applicant

Please enter third joint's last name
Please enter third joint's first name
Please enter third joint's middle name
Please enter third joint's suffix (Sr, Jr, III, etc.)
Please enter your third's joint's maiden name
Please enter your third's joint's email
Please enter your third's joint's street address
Please enter your third's joint's city
Invalid Input
Please enter your third's joint's zip code
Is your mailing address different than above?
You must agree to the disclosures to proceed!
Please enter your third joint's mailing address
Invalid Input
Invalid Input
Invalid Input
Please enter your third joint's date of birth
Please enter your third joint's home phone
Please enter your third joint's cell phone
Please enter your third joint's work phone
Please enter your third joint's driver's license
Invalid Input
Please enter your a valid expiration date
Please enter your third joint's social security number
Please enter your third joint's employer
Please enter your third joint's income
Please enter your third joint's occupation
Rent or Own*
Invalid Input
Page 7

Pay-on-Death Provisions/Beneficiaries

In the event of a death, (or if there is more than one owner of this account, in the event of death of all owners) the owner(s) hereby designate as my/our beneficiary(ies) to receive all sums in my/our account established on this application:
Invalid Input
Please enter the name of payee
Please enter a valid phone number
Please enter an address
Please enter your beneficiary's social security number
Beneficiary's relation to owner
Beneficiary's date of birth
Invalid Input
Please enter a valid phone number
Please enter an address
Please enter your beneficiary's social security number
Beneficiary's relation to owner
Beneficiary's date of birth
Invalid Input
Please enter a valid phone number
Invalid Input
Please enter your beneficiary's social security number
Beneficiary's relation to owner
Beneficiary's date of birth
Page 8

Select Your Accounts

Accounts to be Opened*
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Please note you must print, sign and return your application after pressing submit to complete the membership application process.
Invalid Input
Submit to fill your application for signing.
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