Application Information

Eligibility

• Are your eligible *
  I live, work, worship or volunteer in the counties of Boone, Calhoun, Franklin, Greene, Hamilton, Hardin, Humboldt, Pocahontas, Story, Webster, and Wright. I am a family member of a current People's Credit Union member. I am an employee of a select employee group affiliated with People's Credit Union.
• How did you hear about us? *
  Friend/Family Referral Newspaper Internet Other
• Referral Name
• Please Specify

Application Type

• Individual Account * Joint Account

Account Type

All of the terms, conditions, form of account ownership, account selection and other information indicated on this card apply to all of the accounts listed unless the Credit Union is notified in writing of a change. All accounts require a share/savings account with a minimum $25.00 membership balance.

• Additional Accounts *
  Savings Checking Money Market CD Loan Mortgage Credit Card IRA E-Statements Checks Debit Card Texting Opt-In
• Purpose of Account *
  Personal Business Other
• Please Specify *

Applicant Information

• Name *
• Address *
• City *
• State *
  Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming
• Zip *
• Home Phone *
• Cell Phone
• Work Phone *
• Social Security Number *
• Drivers License State
  Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming
• Drivers License Number *
• Drivers License Issue Date *
• Drivers License Expiration Date *
• Date of Birth *
• Mother's Maiden Name *
• Email
• Occupation *
• Employer *

ID & Address Requirements

All signers acknowledge, authorize and certify:

1. Membership restricted to 11 counties of Boone, Calhoun, Franklin, Green, Hamilton, Hardin, Humboldt, Pocahontas, Story, Webster, and Wright.
2. I will maintain $25 balance as my share of being an owner.
3. Receipt and agreement of Membership Terms & Conditions & Truth In Savings disclosure.
4. People's Credit Union to obtain a consumer credit report and verify my bank accounts to evaluate my credit worthiness.
5. Subscription to Bill Payer Service; authorization for Peoples Credit Union and its agents to process payments to merchants pursuant to payment instructions as account balances allow
6. I certify under penalties of perjury, (1) the number shown on this form is my correct taxpayer identification number and (2) I am not subject to backup withholding as a result of a failure to report all interest or dividends, or the Internal Revenue Service has notified me that I am no longer subject to backup withholding. (3) I am a U.S. citizen (including a U.S. Resident Alien). The Internal Revenue Service does not require your consent to any provision of this document other than the certifications required to avoid backup withholding.
7. Federal law requires all financial institutions to obtain, verify and record information that identifies each person who opens an account, including joint owners and authorized signers. What this means for you: When you open an account, we will ask you for your name, street address, date of birth and other information that will allow us to identify you. We may also ask to see your driver’s license or other identifying documents. It may be necessary for Peoples to restrict account access or delay the approval of loans pending further verification.
8. I understand E-Statements are optional, can be removed by notifying PCU staff at any time, and require Internet and PDF capabilities.

Authorization Agreement

I/We agree to the terms and conditions of the Membership and Account Agreement, Truth-in-Savings Disclosure, Funds availability Policy Disclosure, if applicable, and to any amendment the Credit Union makes from time to time which are incorporated herein. I/We acknowledge receipt of a copy of the agreements and disclosures applicable to the accounts and services requested herein. If an access card or EFT service is requested and provided, I/we agree to the terms of and acknowledge receipt of the Electronic Fund Transfers Agreement and Disclosure. The Internal Revenue Service does not require your consent to any provision of this document other than the certifications required to avoid backup withholding.

The submission of this application will be individual reviewed by a Peoples Credit Union employee within 36 hours. Please ensure your phone number is valid as we will need to reach you and have you sign a form to issue final approval.

• Primary Applicant Date *
• Joint Applicant Date *