Membership Application

To protect your identity we will ask and verify your name, physical street address, date of birth and other information. To verify this information, we may also ask for a copy of your driver license or other identifying documents.

* Indicates a required field of information

How did you hear about us?

Promotional Code:

Account(s) you would like to open

Select all that apply:

Primary Savings

MyLife Free Checking (with FREE Debit Card)

MyLife Money Market

MyLife Premium Money Market

Certificate of Deposit

Debit Card for Primary Owner:

Yes

Debit Card for Joint Owner:

N/A

Yes

Tell us about the Primary Owner/Member

Last Name:

First Name:

Middle Name:

Date of Birth:

/ /

Social Security/Individual Taxpayer ID:

- -

License #:

License State::

Home Street Address:

Home Street Address 2:

City:

State:

ZIP:

Length of time at address::

Email Address:

Home Phone Number:

Cell Phone Number:

Current Employer:

How would you like CME CU to contact you?

Cell Phone Number

Home Phone Number

Tell us about the Joint Owner

Will there be a joint owner on these account(s)?

Yes

No (skip to next section)

Last Name:

First Name:

Middle Name:

Date of Birth:

/ /

Social Security/Individual Taxpayer ID:

- -

License #:

License State::

Street Address (note "same" in first line if it is the same as Primary Member):

Street Address (note "same" in first line if it is the same as Primary Member) 2:

City:

State:

ZIP:

Length of time at address::

Email Address:

Current Employer:

Cell Phone Number:

The Internal Revenue Service does not require your consent to any provision of this contract other than the certifications required to avoid backup withholding.

Backup Withholding Tax:

I AM subject to backup withholding tax

I AM NOT subject to backup withholding tax

Electronic Disclosures: I/We agree to receiving electronic disclosures on our CME CU account(s):

Yes

Important Notice For New Accounts

Federal law requires all financial institutions to obtain, verify and record information that identifies each person opening or having access to an account with CME CU. To meet this, we are required to ask for your legal name, US residential address, Social Security Number (SSN) or Individual Taxpayer Identification Number (ITIN), Phone Number, and Date of Birth.

No person can be named on any account without providing current identification, one that includes a picture and one that reflects the person's current US residential address as given. If the identification form you provided includes both, you only have to submit one.

Agreement & Consent

By submitting my/our application I/we am/are applying for membership to CME CU and certify that:

The information provided on this application is true, correct, and complete. If found to be false CME CU may revoke any and all services it has granted to me.
I/we provide and authorize CME CU to obtain consumer reports, such as credit reports, CheckSystems, and deposit/share account reports, and to gather and exchange whatever credit, account, and employment information CME CU considers appropriate from time to time, and I understand that CME CU may make credit or other decisions based in whole or in part on this information.

I/We agree to the above statement and the required verifications:

Yes

Security Code Verification: