* Required Fields Would you like to open a checking account? Yes No Ownership Information Owner Name: Street Address: Street Address 2: City: State: Select... AL AK AZ AR CA CO CT DE DC FL GA GU HI ID IL IN IA KS KY LA ME MD MA MI MN MS MO MT NE NV NH NJ NM NY NC ND OH OK OR PA RI SC SD TN TX UT VT VA WA WV WI WY ZIP: Phone Number: E-mail Address: Employer: Employer's Phone: Date of Birth: Date of Birth: Month Month... January February March April May June July August September October November December / Date of Birth: Day Day... 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 / Date of Birth: Year Year... 1900 1901 1902 1903 1904 1905 1906 1907 1908 1909 1910 1911 1912 1913 1914 1915 1916 1917 1918 1919 1920 1921 1922 1923 1924 1925 1926 1927 1928 1929 1930 1931 1932 1933 1934 1935 1936 1937 1938 1939 1940 1941 1942 1943 1944 1945 1946 1947 1948 1949 1950 1951 1952 1953 1954 1955 1956 1957 1958 1959 1960 1961 1962 1963 1964 1965 1966 1967 1968 1969 1970 1971 1972 1973 1974 1975 1976 1977 1978 1979 1980 1981 1982 1983 1984 1985 1986 1987 1988 1989 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 2026 2027 2028 2029 2030 2031 2032 2033 2034 2035 2036 2037 2038 2039 2040 2041 2042 2043 2044 Mother's Maiden Name: Type of ID Used to Verify Identity: Driver's License Passport State ID Card Other If Other, please describe: ID Card Number: ID Issue Date: ID Expiration Date: SSN/TIN: Eligibility Based On: Employee of Walled Lake Consolidated School District Employee - City of Walled Lake Employee - City of Wixom Employee - Village of Wolverine Lake Employee - Charter Township of Commerce Spouse of person who was an employee as listed above Retired from one of the employers listed above Immediate family of employee as listed above Organization of people who qualify base on the above criteria Students (kindergarten through 12th-grade) attending Walled Lake Consolidated School District in Walled Lake, Michigan Owner Name (2): Street Address: Street Address 2: City: State: Select... AL AK AZ AR CA CO CT DE DC FL GA GU HI ID IL IN IA KS KY LA ME MD MA MI MN MS MO MT NE NV NH NJ NM NY NC ND OH OK OR PA RI SC SD TN TX UT VT VA WA WV WI WY ZIP: Phone Number: E-mail Address: Employer: Employer's Phone: Date of Birth: Date of Birth: Month Month... January February March April May June July August September October November December / Date of Birth: Day Day... 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 / Date of Birth: Year Year... 1900 1901 1902 1903 1904 1905 1906 1907 1908 1909 1910 1911 1912 1913 1914 1915 1916 1917 1918 1919 1920 1921 1922 1923 1924 1925 1926 1927 1928 1929 1930 1931 1932 1933 1934 1935 1936 1937 1938 1939 1940 1941 1942 1943 1944 1945 1946 1947 1948 1949 1950 1951 1952 1953 1954 1955 1956 1957 1958 1959 1960 1961 1962 1963 1964 1965 1966 1967 1968 1969 1970 1971 1972 1973 1974 1975 1976 1977 1978 1979 1980 1981 1982 1983 1984 1985 1986 1987 1988 1989 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 2026 2027 2028 2029 2030 2031 2032 2033 2034 2035 2036 2037 2038 2039 2040 2041 2042 2043 2044 Mother's Maiden Name: ID Card Number: Driver's License Passport State ID Card Other If Other, please describe: ID Card Number: ID Card Issue Date: ID Card Expiration Date: Eligibility Based On: Employee of Walled Lake Consolidated School District Employee - City of Walled Lake Employee - City of Wixom Employee - Village of Wolverine Lake Employee - Charter Township of Commerce Spouse of person who was an employee as listed above Retired from one of the employers listed above Immediate family of employee as listed above Organization of people who qualify base on the above criteria Students (kindergarten through 12th-grade) attending Walled Lake Consolidated School District in Walled Lake, Michigan SSN/TIN: Owner Name (3): Street Address: City: State: Select... AL AK AZ AR CA CO CT DE DC FL GA GU HI ID IL IN IA KS KY LA ME MD MA MI MN MS MO MT NE NV NH NJ NM NY NC ND OH OK OR PA RI SC SD TN TX UT VT VA WA WV WI WY Zip Code: Phone Number: Email Address: Employer: Employer's Phone: Date of Birth: Date of Birth: Month Month... January February March April May June July August September October November December / Date of Birth: Day Day... 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 / Date of Birth: Year Year... 1900 1901 1902 1903 1904 1905 1906 1907 1908 1909 1910 1911 1912 1913 1914 1915 1916 1917 1918 1919 1920 1921 1922 1923 1924 1925 1926 1927 1928 1929 1930 1931 1932 1933 1934 1935 1936 1937 1938 1939 1940 1941 1942 1943 1944 1945 1946 1947 1948 1949 1950 1951 1952 1953 1954 1955 1956 1957 1958 1959 1960 1961 1962 1963 1964 1965 1966 1967 1968 1969 1970 1971 1972 1973 1974 1975 1976 1977 1978 1979 1980 1981 1982 1983 1984 1985 1986 1987 1988 1989 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 2026 2027 2028 2029 2030 2031 2032 2033 2034 2035 2036 2037 2038 2039 2040 2041 2042 2043 2044 Mother's Maiden Name: Type of ID Used to Verify Identity: Driver's License Passport State ID Card Other If Other, please describe: ID Card Number: ID Card Issue Date: ID Card Expiration Date: SSN/TIN: Eligibility Based On: Employee of Walled Lake Consolidated School District Employee - City of Walled Lake Employee - City of Wixom Employee - Village of Wolverine Lake Employee - Charter Township of Commerce Spouse of person who was an employee as listed above Retired from one of the employers listed above Immediate family of employee as listed above Organization of people who qualify base on the above criteria Students (kindergarten through 12th-grade) attending Walled Lake Consolidated School District in Walled Lake, Michigan TIN Certification and Backup Withholding Information Under penalties of perjury, I certify that (please check all that apply):: The number shown on this form is my correct taxpayer identification number 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 The IRS has notified me that I am no longer subject to backup withholding I am a U.S. person (including a U.S. resident alien) Multiple Name Account Agreement The joint owners of this account hereby agree with each other and with the credit union that all sums now paid into this account, by any or all of said joint owners with all accumulations thereon, are and shall be owned by them jointly, with right of survivorship, and shall be subject to withdrawal or receipt of any of them, except to the extent an initialed restriction below applies. Payment in accordance with such a proper demand shall be valid and discharge the credit union from any liability for such payment. The credit union is hereby authorized to recognize the signatures(s) subscribed above, in accordance with the restrictions initialed below, in the payment of funds or the transaction of any business for this account. The right or authority of the credit union under this agreement shall not be changed by any owners, except by written notice to the credit union. Such notice shall not affect any transactions made prior to receipt of the notice by the credit union. Withdrawal Restrictions: Any owner of this account may make a withdrawal without the signature of any other owner Signatures of all living owners required for any withdrawal. Beneficiary Information and Provisions Upon the death of the owner, or the last surviving owner if there is more than one, the funds covered by this agreement shall become the property of the beneficiary(ies) listed below who are alive at the time. In addition, each such beneficiary shall have the power to withdraw only his or her equal share of the remaining account balance together with any accumulations on such amount. The multiple name account agreement (Part III) shall not apply to beneficiaries. No beneficiary shall have any right under any circumstances to change the terms and conditions of this agreement. Beneficiary Names: Acknowledgement Acknowledgement: I/we have read Walled Lake Schools Federal Credit Union's account disclosures. I/we agree to be bound by all of the terms and conditions of the disclosures and this application and any amendments thereto or to those contained in any membership agreement and disclosures provided to me/us at any time which conditions contained therein are fully incorporated herein. I/we certify that the information on this application is true and correct. I/we understand that this account is established subject to the laws of the State of Michigan. The Walled Lake Schools Federal Credit Union is authorized to make whatever inquiries it deems necessary of others concerning the information contained in this application and to provide information arising out of my/our transactions with the Credit Union with consumer reporting agencies. DISCLAIMER: I/WE HEREBY CERTIFY THAT ALL STATEMENTS MADE ARE TRUE AND COMPLETE, ARE SUBMITTED FOR THE PURPOSE OF OBTAINING CREDIT, AND THAT THE CREDIT UNION MAY RELY ON THEM FOR SUCH DETERMINATION. WE UNDERSTAND THAT FEDERAL LAW REQUIRES THE VERIFICATION OF IDENTIFICATION FOR ALL NEW ACCOUNTS SHOULD I NOT HAVE AN EXISTING ACCOUNT. I/WE AUTHORIZE YOU TO OBTAIN SUCH INFORMATION AS YOU MAY REQUIRE CONCERNING THE STATEMENTS MADE IN THIS APPLICATION AND PROPER IDENTIFICATION, AND AGREE THAT THE APPLICATION SHALL REMAIN YOUR PROPERTY, AND YOU ARE AUTHORIZED TO ANSWER QUESTIONS ABOUT YOUR CREDIT EXPERIENCE WITH ME/US. I accept : I accept the terms of the disclaimer above and submit my application Security Code: Security Code Go to main navigation
