BusinessApplication 033012
Please do not staple
Business Membership and Account Application Required Field (use the Tab Key to jump to the next field when completing in Adobe Acrobat)
Credit Union Use Only Member #:_ ______________________
Account Ownership Requested:
✔ Corporate o
o Partnership
o Sole Proprietorship
o Association o Organization
o Update of Existing Account
Eligibility: I/We are eligible for membership because
o Our business / association is expressly named in the Credit Union bylaws o All owners of the business are within the Credit Union’s field of membership (below): o Firefighter o Related to a Member ( Name:.............................................................) o Other............................................................................................................................ Services:
o Business Checking ( o Checks o ATM Debit Card ) see Appendix 1
o Money Market
o Term Certificate
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
Please have the following documents ready, as applicable: Articles of Incorporation, Business License, Ficticious Business Name Statement, Letters of Authorization
Name of Business/Association
Tax ID Number
Type of Business
Date Business Opened
Business Address (Street, City, State, Zip) Mailing Address o Same as Business Address Business Phone
Business Email
Security Password*
Current Directors, Partners, Officers or Sole Owner Last Name
First Name
Middle Initial
DOB
Citizenship o US Citizen o Perm Resident o Non-Perm Resident If not a US citizen, indicate country of origin
Mother’s Maiden Name
SSN#
Photo ID Type (ie License)
ID Number
Business Title
Residence o Same as Business
Phone
Email
Last Name
First Name
Middle Initial
Citizenship o US Citizen o Perm Resident o Non-Perm Resident If not a US citizen, indicate country of origin
Mother’s Maiden Name
SSN#
Photo ID Type (ie License)
ID Number
Business Title
Residence o Same as Business
Phone
Email
Last Name
First Name
Middle Initial
Citizenship o US Citizen o Perm Resident o Non-Perm Resident If not a US citizen, indicate country of origin
Mother’s Maiden Name
SSN#
Photo ID Type (ie License)
ID Number
Business Title
Residence o Same as Business
Phone
Email
DOB
DOB
Authorized Signers Only Full Name
Sign Here
Title
DOB
SSN#
Full Name
Sign Here
Title
DOB
SSN#
Full Name
Sign Here
Title
DOB
SSN#
Today’s Date
Today’s Date
Today’s Date
For additional Authorized Signers and/or Directors, Partners, Officers, please request Supplemental 1. * 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, online or in person.
Page 1 of 2
(032312)
Please do not staple
Business Membership and Account Application Required Field
Member #:_ _____________ – ______
Request for Tax Payer Information Part I : Enter you Taxpayer Identification Number (TIN). For individuals, this is your Social Security Number (SSN) or Employer Identification Number (EIN). For Corporations, Associations and Partnerships, this is your EIN. T.I.N. (Social Security Number):_ __________________________________
E.I.N. (Employer Identification Number):_ ___________________________
Part II : For payees exempt from backup withholdings, see IRS instructions to Part II available from a Credit Union employee. Part III : Under penalties of perjury, you certify that (1) The number shown on this form is your correct TIN, and (2) You are not subject to back up withholding.
o You agree to cross out Part II above and check the box if you have been notified by the IRS that you are currently subject to back up withholding because of underreporting interest or dividends on your tax returns. Signature:_ _______________________________________________________________________________
SF Fire Credit Union deposits are insured by American Share Insurance, the largest provider of private share insurance. Each SF Fire Credit Union deposit and certificate account is insured up to $500,000.
Date:_________________
This institution is not federally insured, and if the institution fails, the Federal Government does not guarantee depositors will get back their money. Accounts with this institution are not insured by any state government.
Proxy: I appoint the Board of Directors of SF Fire Credit Union to appoint a Proxy to represent me at all meetings of the members of the Credit Union. The Proxy will vote for me on all questions and elections coming before said meeting, to give consent and in other ways to act in my place and stead. This Proxy shall remain in force for three years from today unless revoked by me in writing or revoked by subsequent Proxy. This Proxy will be withdrawn from any meeting, which I attend and vote in person.
By signing below, I/we agree to the terms and conditions of the Truth in Savings(TIS)/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. Signature:_ _______________________________________________________________________________
Date:_________________
Print name here, then sign at right
Date:_________________
Print name here, then sign at right
Date:_________________
Signature:_ _______________________________________________________________________________ Signature:_ _______________________________________________________________________________
For additional Authorized Signers and/or Directors, Partners, Officers, please request Supplemental 1.
For Credit Union Use Only – Verification of Right to Do Business
o Articles of Incorporation o Business License o Fictitious Business Name Statement
o Resolution o EIN Statement o Interview Sheet
o Card Ordered o Checks Ordered o Letters of Authorization
Membership Officer:_ ____________________________________ SDID#:_ ________________________________ Date:____________________
For Credit Union Use Only ID Verified By:_ ________________________________________ User ID ChexSystem:_ ________________________ Date:____________________
Page 2 of 2
(03/12)
Please do not staple
Business Membership and Account Application Required Field
Member #:______________ – ______
An overdraft occurs when you do not have enough money in your account to cover a transaction and SF Fire Credit Union pays it anyway. There are several ways we can cover your overdraft: FREE Overdraft Protection We attempt to cover your overdraft transactions by first using available funds in your deposit accounts – and if no funds are available, then from an alternative SF Fire Credit Union account. There are NO FEES associated with using your SF Fire Credit Union accounts to cover overdrafts. Using a Deposit Account a Source of FREE Overdraft Protection Deposit Accounts (ie Money Market): Each SF Fire Credit Union deposit account can have up to six electronic transfers per month, * – meaning transactions not performed in-person, with a Call Center representative or at an ATM – as long as there are available funds in the account. * E-alerts within Online Banking can help you keep track of account balances or how many transfers remain on your deposit accounts. Log in or contact us to activate. Designating Your Sources When attempting to cover your overdraft transactions, we’ll first seek available funds in your primary (1st) account. If you would like to change this order – or use different accounts – please indicate this below: Source of Overdraft Protection Your Preferred Order – please indicate 1st or 2nd (if selecting more than one source) ✔ Money Market o _________ o OTHER SF Fire Account (ie your personal Visa Credit Card **): _________ If you select the above, what is your other SF Fire Member #______________ ** Your personal Visa® Credit Card: any SF Fire Credit Union Visa Credit Card that you designate as a source of Overdraft Protection can be used to cover an unlimited number of overdraft transactions in a given month – as long as there is available credit. Note: While there is NO FEE associated with using your Visa as a source of Overdraft Protection, finance charges on the overdraft amount will begin accruing immediately.
o NO, THANKS. I wish to decline free Overdraft Protection.
Acknowledgement of Fees I acknowledge that I have received a copy of the Fee Schedule for Business Accounts:
Signature:________________________________________________________________________________
_________________ (initial)
Date:_________________
Print name here, then sign at right Signature:________________________________________________________________________________ Date:_________________ Print name here, then sign at right Signature:________________________________________________________________________________ Date:_________________
Print name here, then sign at right Signature:________________________________________________________________________________ Date:_________________
APPENDIX 1
(022313)
Please do not staple
Business Membership and Account Application Required Field
Member #:_ _____________ – ______
Current Directors, Partners, or Officers (continued) Last Name
First Name
Middle Initial
Citizenship o US Citizen o Perm Resident o Non-Perm Resident If not a US citizen, indicate country of origin
Mother’s Maiden Name
SSN#
Photo ID Type (ie License)
ID Number
Business Title
Residence o Same as Business
Phone
Email
Last Name
First Name
Middle Initial
Citizenship o US Citizen o Perm Resident o Non-Perm Resident If not a US citizen, indicate country of origin
Mother’s Maiden Name
SSN#
Photo ID Type (ie License)
ID Number
Business Title
Residence o Same as Business
Phone
Email
Last Name
First Name
Middle Initial
Citizenship o US Citizen o Perm Resident o Non-Perm Resident If not a US citizen, indicate country of origin
Mother’s Maiden Name
SSN#
Photo ID Type (ie License)
ID Number
Business Title
Residence o Same as Business
Phone
Email
Last Name
First Name
Middle Initial
Citizenship o US Citizen o Perm Resident o Non-Perm Resident If not a US citizen, indicate country of origin
Mother’s Maiden Name
SSN#
Photo ID Type (ie License)
ID Number
Business Title
Residence o Same as Business
Phone
Email
Last Name
First Name
Middle Initial
Citizenship o US Citizen o Perm Resident o Non-Perm Resident If not a US citizen, indicate country of origin
Mother’s Maiden Name
SSN#
Photo ID Type (ie License)
ID Number
Business Title
Residence o Same as Business
Phone
Email
DOB
DOB
DOB
DOB
DOB
Authorized Signers Only (continued) Full Name
Sign Here
Title
DOB
SSN#
Full Name
Sign Here
Title
DOB
SSN#
Full Name
Sign Here
Title
DOB
SSN#
Full Name
Sign Here
Title
DOB
SSN#
Full Name
Sign Here
Title
DOB
SSN#
Today’s Date
Today’s Date
Today’s Date
Today’s Date
Today’s Date
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.
SUPPLEMENTAL 1
(032312)
Business Membership and Account Application Required Field (use the Tab Key to jump to the next field when completing in Adobe Acrobat)
Credit Union Use Only Member #:_ ______________________
Account Ownership Requested:
✔ Corporate o
o Partnership
o Sole Proprietorship
o Association o Organization
o Update of Existing Account
Eligibility: I/We are eligible for membership because
o Our business / association is expressly named in the Credit Union bylaws o All owners of the business are within the Credit Union’s field of membership (below): o Firefighter o Related to a Member ( Name:.............................................................) o Other............................................................................................................................ Services:
o Business Checking ( o Checks o ATM Debit Card ) see Appendix 1
o Money Market
o Term Certificate
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
Please have the following documents ready, as applicable: Articles of Incorporation, Business License, Ficticious Business Name Statement, Letters of Authorization
Name of Business/Association
Tax ID Number
Type of Business
Date Business Opened
Business Address (Street, City, State, Zip) Mailing Address o Same as Business Address Business Phone
Business Email
Security Password*
Current Directors, Partners, Officers or Sole Owner Last Name
First Name
Middle Initial
DOB
Citizenship o US Citizen o Perm Resident o Non-Perm Resident If not a US citizen, indicate country of origin
Mother’s Maiden Name
SSN#
Photo ID Type (ie License)
ID Number
Business Title
Residence o Same as Business
Phone
Last Name
First Name
Middle Initial
Citizenship o US Citizen o Perm Resident o Non-Perm Resident If not a US citizen, indicate country of origin
Mother’s Maiden Name
SSN#
Photo ID Type (ie License)
ID Number
Business Title
Residence o Same as Business
Phone
Last Name
First Name
Middle Initial
Citizenship o US Citizen o Perm Resident o Non-Perm Resident If not a US citizen, indicate country of origin
Mother’s Maiden Name
SSN#
Photo ID Type (ie License)
ID Number
Business Title
Residence o Same as Business
Phone
DOB
DOB
Authorized Signers Only Full Name
Sign Here
Title
DOB
SSN#
Full Name
Sign Here
Title
DOB
SSN#
Full Name
Sign Here
Title
DOB
SSN#
Today’s Date
Today’s Date
Today’s Date
For additional Authorized Signers and/or Directors, Partners, Officers, please request Supplemental 1. * 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, online or in person.
Page 1 of 2
(032312)
Please do not staple
Business Membership and Account Application Required Field
Member #:_ _____________ – ______
Request for Tax Payer Information Part I : Enter you Taxpayer Identification Number (TIN). For individuals, this is your Social Security Number (SSN) or Employer Identification Number (EIN). For Corporations, Associations and Partnerships, this is your EIN. T.I.N. (Social Security Number):_ __________________________________
E.I.N. (Employer Identification Number):_ ___________________________
Part II : For payees exempt from backup withholdings, see IRS instructions to Part II available from a Credit Union employee. Part III : Under penalties of perjury, you certify that (1) The number shown on this form is your correct TIN, and (2) You are not subject to back up withholding.
o You agree to cross out Part II above and check the box if you have been notified by the IRS that you are currently subject to back up withholding because of underreporting interest or dividends on your tax returns. Signature:_ _______________________________________________________________________________
SF Fire Credit Union deposits are insured by American Share Insurance, the largest provider of private share insurance. Each SF Fire Credit Union deposit and certificate account is insured up to $500,000.
Date:_________________
This institution is not federally insured, and if the institution fails, the Federal Government does not guarantee depositors will get back their money. Accounts with this institution are not insured by any state government.
Proxy: I appoint the Board of Directors of SF Fire Credit Union to appoint a Proxy to represent me at all meetings of the members of the Credit Union. The Proxy will vote for me on all questions and elections coming before said meeting, to give consent and in other ways to act in my place and stead. This Proxy shall remain in force for three years from today unless revoked by me in writing or revoked by subsequent Proxy. This Proxy will be withdrawn from any meeting, which I attend and vote in person.
By signing below, I/we agree to the terms and conditions of the Truth in Savings(TIS)/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. Signature:_ _______________________________________________________________________________
Date:_________________
Print name here, then sign at right
Date:_________________
Print name here, then sign at right
Date:_________________
Signature:_ _______________________________________________________________________________ Signature:_ _______________________________________________________________________________
For additional Authorized Signers and/or Directors, Partners, Officers, please request Supplemental 1.
For Credit Union Use Only – Verification of Right to Do Business
o Articles of Incorporation o Business License o Fictitious Business Name Statement
o Resolution o EIN Statement o Interview Sheet
o Card Ordered o Checks Ordered o Letters of Authorization
Membership Officer:_ ____________________________________ SDID#:_ ________________________________ Date:____________________
For Credit Union Use Only ID Verified By:_ ________________________________________ User ID ChexSystem:_ ________________________ Date:____________________
Page 2 of 2
(03/12)
Please do not staple
Business Membership and Account Application Required Field
Member #:______________ – ______
An overdraft occurs when you do not have enough money in your account to cover a transaction and SF Fire Credit Union pays it anyway. There are several ways we can cover your overdraft: FREE Overdraft Protection We attempt to cover your overdraft transactions by first using available funds in your deposit accounts – and if no funds are available, then from an alternative SF Fire Credit Union account. There are NO FEES associated with using your SF Fire Credit Union accounts to cover overdrafts. Using a Deposit Account a Source of FREE Overdraft Protection Deposit Accounts (ie Money Market): Each SF Fire Credit Union deposit account can have up to six electronic transfers per month, * – meaning transactions not performed in-person, with a Call Center representative or at an ATM – as long as there are available funds in the account. * E-alerts within Online Banking can help you keep track of account balances or how many transfers remain on your deposit accounts. Log in or contact us to activate. Designating Your Sources When attempting to cover your overdraft transactions, we’ll first seek available funds in your primary (1st) account. If you would like to change this order – or use different accounts – please indicate this below: Source of Overdraft Protection Your Preferred Order – please indicate 1st or 2nd (if selecting more than one source) ✔ Money Market o _________ o OTHER SF Fire Account (ie your personal Visa Credit Card **): _________ If you select the above, what is your other SF Fire Member #______________ ** Your personal Visa® Credit Card: any SF Fire Credit Union Visa Credit Card that you designate as a source of Overdraft Protection can be used to cover an unlimited number of overdraft transactions in a given month – as long as there is available credit. Note: While there is NO FEE associated with using your Visa as a source of Overdraft Protection, finance charges on the overdraft amount will begin accruing immediately.
o NO, THANKS. I wish to decline free Overdraft Protection.
Acknowledgement of Fees I acknowledge that I have received a copy of the Fee Schedule for Business Accounts:
Signature:________________________________________________________________________________
_________________ (initial)
Date:_________________
Print name here, then sign at right Signature:________________________________________________________________________________ Date:_________________ Print name here, then sign at right Signature:________________________________________________________________________________ Date:_________________
Print name here, then sign at right Signature:________________________________________________________________________________ Date:_________________
APPENDIX 1
(022313)
Please do not staple
Business Membership and Account Application Required Field
Member #:_ _____________ – ______
Current Directors, Partners, or Officers (continued) Last Name
First Name
Middle Initial
Citizenship o US Citizen o Perm Resident o Non-Perm Resident If not a US citizen, indicate country of origin
Mother’s Maiden Name
SSN#
Photo ID Type (ie License)
ID Number
Business Title
Residence o Same as Business
Phone
Last Name
First Name
Middle Initial
Citizenship o US Citizen o Perm Resident o Non-Perm Resident If not a US citizen, indicate country of origin
Mother’s Maiden Name
SSN#
Photo ID Type (ie License)
ID Number
Business Title
Residence o Same as Business
Phone
Last Name
First Name
Middle Initial
Citizenship o US Citizen o Perm Resident o Non-Perm Resident If not a US citizen, indicate country of origin
Mother’s Maiden Name
SSN#
Photo ID Type (ie License)
ID Number
Business Title
Residence o Same as Business
Phone
Last Name
First Name
Middle Initial
Citizenship o US Citizen o Perm Resident o Non-Perm Resident If not a US citizen, indicate country of origin
Mother’s Maiden Name
SSN#
Photo ID Type (ie License)
ID Number
Business Title
Residence o Same as Business
Phone
Last Name
First Name
Middle Initial
Citizenship o US Citizen o Perm Resident o Non-Perm Resident If not a US citizen, indicate country of origin
Mother’s Maiden Name
SSN#
Photo ID Type (ie License)
ID Number
Business Title
Residence o Same as Business
Phone
DOB
DOB
DOB
DOB
DOB
Authorized Signers Only (continued) Full Name
Sign Here
Title
DOB
SSN#
Full Name
Sign Here
Title
DOB
SSN#
Full Name
Sign Here
Title
DOB
SSN#
Full Name
Sign Here
Title
DOB
SSN#
Full Name
Sign Here
Title
DOB
SSN#
Today’s Date
Today’s Date
Today’s Date
Today’s Date
Today’s Date
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.
SUPPLEMENTAL 1
(032312)
