Business membership app 2011
Business
Membership
and
App l i c a t i o n
For Credit Union Use Only
Member Name:
SDID#
Member Number:
Account Ownership Requested: oCorporate Eligibility:
Account
oPartnership
oSole Proprietorship
oAssociation
oOrganization
I/We are eligible for membership because: oOur Business/Association is expressly named in the Credit Union bylaws. oAll Owners of the business are within the Credit Union’s field of membership. oFamily oOther: oFirefighter
Please check services you would like: oBusiness Checking
oSavings oOverdraft Protection
oMoney Market oTerm Investment
oATM/Debit Card
The undersigned is authorized and does hereby make application for membership in the SF Fire Credit Union , and agrees to conform to its bylaws and the terms and conditions of the General Disclosure and Account Agreement, and Truth-in-Savings Disclosure, and agrees to provide documentation evidencing said authority. Business Membership Name of Business/Association
Date Business Opened
Type of Business Business Address City
State
Zip
Business Telephone
Tax ID Number
E-mail Address
Current directors, partners, officers or sole owner Last Name
Social Security Number
Residence Address
Last Name
Middle Initial
Title
Driver License/State ID Card
Date of Birth
E-mail Address
City
State
Zip
Home Phone
First Name
Middle Initial
Title
Social Security Number
Driver License/State ID Card
Date of Birth
E-mail Address
AResidence Address
City
State
Zip
Home Phone
Last Name
First Name
Middle Initial
Title
Social Security Number
Driver License/State ID Card
Date of Birth
E-mail Address
Residence Address
State
Zip
Home Phone
First Name
City
Authorized signers only Authorized Signer
Date
Name (Print)
Title
Authorized Signer
Date
Name (Print)
Title
Authorized Signer
Date
Name (Print)
Title
Social Security
Social Security
Social Security
For Identification purposes, you and any joint owner agree to provide your security password each time you conduct business with the Credit Union, either over the phone or in person. Please see reverse to complete form
Member Name: _____________________________________________
Member Number: ________________
Name of Trust: ____________________________________________________________________Separate Agreement Date:_______________________
T R Name of Trustor:__________________________________________________________________________________________________________________ U For Credit Union I/We declare under penalty of perjury and as provided under the California Probate Use CodeOnly Section 18100-5 that I/we/am/are qualified and have the power to act and S am/are properly exercising the powers under the above named trust. Member Name: ______________________________________________________________ Member Number:_________________________ T REQUEST FOR TAXPAYER IDENTIFICATION NUMBER X______________________________________________________ X_____________________________________________________________ Signature of Trustee Signature of Trustee Part I: Enter your Taxpayer Identification Number (TIN) in the spaces. For Sole Proprietorship this is your SSN or EIN. For Corporations, Associations, and Partnerships, this is your EIN. Funds to remain in Trust until age: __________ TIN: (Optional): In the event that the custodian originally EIN: APPOINTMENT OF GUARDIAN named shall be unable to act as custodian, declines to accept the
_ _ _ -_ _ -_ _ _ _
U
_ _ -_ _ _ _ _ _ _
custodianship, resigns, dies, or becomes legally incapacitated, the person named below is designated a successor custodian. (Social Security No.) (Employer Identification No.)
Part T II: For payees exempt from backup withholding, see IRS instructions to Part II available from a Credit Union employee.
M ________________________________________________ __________________________________________________________________________ Part Under penalties and perjury, you certify that: (1) The number shown Name Addresson this form is your correct TIN; and (2) your are not subject to backup A III: withholding. oYou agree to cross out Part II above and check this box if you have been notified by the IRS that you are currently subject to backup withholding X_____________________________________________________ X_________________________________________________________________ because Signature of underreporting interest or dividends on your tax return. Date of Custodian Witness (other than successor custodian) Date
Fiduciary Trust Account by Court Order Name of Trustor______________________________________________________________________________ SIGNATURE DATE
SF Fire CU Deposits are insured by American Insurance, the largest Deposits Share in SFFCU are insured by American Share provider of private shareprovider Insurance. Each Insurance, the largest of private share SF Fire CreditEach Union deposit and certifiInsurance. SFFCU deposit and certificate account is is insured cate account insuredupuptoto$500,000. $500,000. This insured, and and ififthe theinstitution institutionfails, fails, Thisinstitution institution is is not not federally federally insured, thethe FederFederal al Government doesnot notguarantee guaranteethat thatdepositors depositorswill will back their money. Government does getget back their money. Accountswith with this institution this institution are Accounts arenot notinsured insuredbybyany anystate stategovernment. government.
̝
Account Blocked
PROXY: I appoint the Board of Directors of SF Fire CU to appoint a Proxy to represent at all meetings members of the Credit Union. The Proxy will PROXY: me I appoint the Boardofofthe Directors of SFFCU to appoint a Proxy to represent vote on all of questions and elections coming before said meeting, me atfor all me meetings the members of the Credit Union. The Proxy will votetoforgive me on consent and in other ways coming to act inbefore my place stead.toThis shall all questions and elections said and meeting, giveproxy consent andremain in other in force forinthree yearsand from today, unless by me in writing or revoked ways to act my place stead. This proxyrevoked shall remain in force for three years from today, unless revoked meProxy in writing or withdrawn revoked by from subsequent Proxy. This Proxy by subsequent Proxy. by This will be any meeting, which I will be and withdrawn any meeting, which I attend and vote in person. attend vote infrom person.
By signing below, I/We agree to the terms and conditions of the Truth in Savings/Rate/Fee Schedule and to any amendments thereto which are by this reference incorporated in their entirety into the disclosure. I/We agree to be bound by the terms and conditions of the disclosures and application. I/We understand the credit union will mail the TIS, Fee and Rate Schedule within 10 days of receipt of this application. I/We authorize you to gather any credit, checking account and employment information deemed appropriate from time to time.
X___________________________________________
X
Member Signature
Date
Member Signature
Date
X___________________________________________ Member Signature
Date
TO BE COMPLETED BY SAN FRANCISCO FIRE CREDIT UNION BASIC SHARE (SAVINGS) ACCOUNT
CHECKING ACCOUNT
ADDITIONAL SHARE ACCOUNT
OTHER
Share ID____________________
Share ID_________________
Share ID_________________
Share ID_______________
Open Date__________________
Open Date_______________
Open Date_______________
Open Date_____________
User ID_____________________
User ID__________________ User VERIFICATION OF RIGHT ID__________________ TO DO BUSINESS
User ID________________
ChexSystems______________
ChexSystems___________
Verification of right to do business by receipt of: ChexSystems________________ oArticles of Incorporation
For Credit Union Use Only
ChexSystems_____________
oFictitious Business Name Statement
oBusiness License oLetters of Authorization ____________________________________________________________________ Membership Officer Membership officer Date
Id Verfied By
oResolution
By ID VerifiedDATE
_____________________________________________
User ID Chexsystem
SFF-124 (04/05)
Type of Account Opened Revised (07/08)
Membership
and
App l i c a t i o n
For Credit Union Use Only
Member Name:
SDID#
Member Number:
Account Ownership Requested: oCorporate Eligibility:
Account
oPartnership
oSole Proprietorship
oAssociation
oOrganization
I/We are eligible for membership because: oOur Business/Association is expressly named in the Credit Union bylaws. oAll Owners of the business are within the Credit Union’s field of membership. oFamily oOther: oFirefighter
Please check services you would like: oBusiness Checking
oSavings oOverdraft Protection
oMoney Market oTerm Investment
oATM/Debit Card
The undersigned is authorized and does hereby make application for membership in the SF Fire Credit Union , and agrees to conform to its bylaws and the terms and conditions of the General Disclosure and Account Agreement, and Truth-in-Savings Disclosure, and agrees to provide documentation evidencing said authority. Business Membership Name of Business/Association
Date Business Opened
Type of Business Business Address City
State
Zip
Business Telephone
Tax ID Number
E-mail Address
Current directors, partners, officers or sole owner Last Name
Social Security Number
Residence Address
Last Name
Middle Initial
Title
Driver License/State ID Card
Date of Birth
E-mail Address
City
State
Zip
Home Phone
First Name
Middle Initial
Title
Social Security Number
Driver License/State ID Card
Date of Birth
E-mail Address
AResidence Address
City
State
Zip
Home Phone
Last Name
First Name
Middle Initial
Title
Social Security Number
Driver License/State ID Card
Date of Birth
E-mail Address
Residence Address
State
Zip
Home Phone
First Name
City
Authorized signers only Authorized Signer
Date
Name (Print)
Title
Authorized Signer
Date
Name (Print)
Title
Authorized Signer
Date
Name (Print)
Title
Social Security
Social Security
Social Security
For Identification purposes, you and any joint owner agree to provide your security password each time you conduct business with the Credit Union, either over the phone or in person. Please see reverse to complete form
Member Name: _____________________________________________
Member Number: ________________
Name of Trust: ____________________________________________________________________Separate Agreement Date:_______________________
T R Name of Trustor:__________________________________________________________________________________________________________________ U For Credit Union I/We declare under penalty of perjury and as provided under the California Probate Use CodeOnly Section 18100-5 that I/we/am/are qualified and have the power to act and S am/are properly exercising the powers under the above named trust. Member Name: ______________________________________________________________ Member Number:_________________________ T REQUEST FOR TAXPAYER IDENTIFICATION NUMBER X______________________________________________________ X_____________________________________________________________ Signature of Trustee Signature of Trustee Part I: Enter your Taxpayer Identification Number (TIN) in the spaces. For Sole Proprietorship this is your SSN or EIN. For Corporations, Associations, and Partnerships, this is your EIN. Funds to remain in Trust until age: __________ TIN: (Optional): In the event that the custodian originally EIN: APPOINTMENT OF GUARDIAN named shall be unable to act as custodian, declines to accept the
_ _ _ -_ _ -_ _ _ _
U
_ _ -_ _ _ _ _ _ _
custodianship, resigns, dies, or becomes legally incapacitated, the person named below is designated a successor custodian. (Social Security No.) (Employer Identification No.)
Part T II: For payees exempt from backup withholding, see IRS instructions to Part II available from a Credit Union employee.
M ________________________________________________ __________________________________________________________________________ Part Under penalties and perjury, you certify that: (1) The number shown Name Addresson this form is your correct TIN; and (2) your are not subject to backup A III: withholding. oYou agree to cross out Part II above and check this box if you have been notified by the IRS that you are currently subject to backup withholding X_____________________________________________________ X_________________________________________________________________ because Signature of underreporting interest or dividends on your tax return. Date of Custodian Witness (other than successor custodian) Date
Fiduciary Trust Account by Court Order Name of Trustor______________________________________________________________________________ SIGNATURE DATE
SF Fire CU Deposits are insured by American Insurance, the largest Deposits Share in SFFCU are insured by American Share provider of private shareprovider Insurance. Each Insurance, the largest of private share SF Fire CreditEach Union deposit and certifiInsurance. SFFCU deposit and certificate account is is insured cate account insuredupuptoto$500,000. $500,000. This insured, and and ififthe theinstitution institutionfails, fails, Thisinstitution institution is is not not federally federally insured, thethe FederFederal al Government doesnot notguarantee guaranteethat thatdepositors depositorswill will back their money. Government does getget back their money. Accountswith with this institution this institution are Accounts arenot notinsured insuredbybyany anystate stategovernment. government.
̝
Account Blocked
PROXY: I appoint the Board of Directors of SF Fire CU to appoint a Proxy to represent at all meetings members of the Credit Union. The Proxy will PROXY: me I appoint the Boardofofthe Directors of SFFCU to appoint a Proxy to represent vote on all of questions and elections coming before said meeting, me atfor all me meetings the members of the Credit Union. The Proxy will votetoforgive me on consent and in other ways coming to act inbefore my place stead.toThis shall all questions and elections said and meeting, giveproxy consent andremain in other in force forinthree yearsand from today, unless by me in writing or revoked ways to act my place stead. This proxyrevoked shall remain in force for three years from today, unless revoked meProxy in writing or withdrawn revoked by from subsequent Proxy. This Proxy by subsequent Proxy. by This will be any meeting, which I will be and withdrawn any meeting, which I attend and vote in person. attend vote infrom person.
By signing below, I/We agree to the terms and conditions of the Truth in Savings/Rate/Fee Schedule and to any amendments thereto which are by this reference incorporated in their entirety into the disclosure. I/We agree to be bound by the terms and conditions of the disclosures and application. I/We understand the credit union will mail the TIS, Fee and Rate Schedule within 10 days of receipt of this application. I/We authorize you to gather any credit, checking account and employment information deemed appropriate from time to time.
X___________________________________________
X
Member Signature
Date
Member Signature
Date
X___________________________________________ Member Signature
Date
TO BE COMPLETED BY SAN FRANCISCO FIRE CREDIT UNION BASIC SHARE (SAVINGS) ACCOUNT
CHECKING ACCOUNT
ADDITIONAL SHARE ACCOUNT
OTHER
Share ID____________________
Share ID_________________
Share ID_________________
Share ID_______________
Open Date__________________
Open Date_______________
Open Date_______________
Open Date_____________
User ID_____________________
User ID__________________ User VERIFICATION OF RIGHT ID__________________ TO DO BUSINESS
User ID________________
ChexSystems______________
ChexSystems___________
Verification of right to do business by receipt of: ChexSystems________________ oArticles of Incorporation
For Credit Union Use Only
ChexSystems_____________
oFictitious Business Name Statement
oBusiness License oLetters of Authorization ____________________________________________________________________ Membership Officer Membership officer Date
Id Verfied By
oResolution
By ID VerifiedDATE
_____________________________________________
User ID Chexsystem
SFF-124 (04/05)
Type of Account Opened Revised (07/08)
