Checking Account Application 2023.02

Checking Account & Visa(R) Debit Card Application

Account Number *

Last Name *

First Name *

Middle Name or MI

Social Security Number *

Mother's Maiden Name *

Your Date of Birth *

Address *

City *

State *

Zip Code *

Phone *

Phone Type *

Mobile

Home

Work

Email *

Checking Account Set-up

Minimum Initial Deposit *

I understand that to open my Checking Account and order my Visa® Debit Card, I will need to have on deposit at least $30.

Transfer

Transfer the following amount from my Credit Union Savings Account to my new Checking Account.

Transfer Amount $

Other Deposit

I will be depositing additional funds into my account for the purpose of opening of Checking Account.

Order Checks

I would like to order paper checks for my Checking Account (Need at least $50 on deposit in the credit union to cover cost of checks.)

Check Options

Please Print My Name & Address

Please Print My Name, Address & Phone Number

Contact me regarding my check order

Overdraft Protection & Overdraft Service for ATM & Debit Card

Overdraft Protection - Fees Apply

I would overdrafts to be paid from my Savings Account first.

By default, you are opted "IN" for the Credit Union to authorize and pay overdrafts on ATM & everyday debit card transactions. This option allows for a negative balance and we will authorize & pay ATM and everyday debit card transactions up to a calculated amount. There is a fee for this service.

Overdraft Service for ATM & Everyday Debit Card Transactions *

I want to CONTINUE to have the Credit Union to authorize and pay overdrafts on ATM & everyday debit card transactions.

I do NOT want the Credit Union to authorize and pay overdrafts on ATM & everyday debit card transactions.

I am unsure of this service, please contact me.

Agreement

I agree that I will be bound by terms of the Union Pacific Streamliner Federal Credit Union Checking Account agreement & disclosure which will be furnished to me. I agree to surrender the card upon demand and authorize the credit union to obtain credit reports and other consumer reports in connection with this application and for any update or renewal of the card.

Electronic Funds Transfer Disclosure

Rate and Fee Disclosure

Funds Availability Disclosure

Thank You for Submitting Your Checking Account & Debit Card Application. We'll be processing it and let you know the progress.

WWW.UPCU.ORG

800.370.2260

memberservice@upcu.org