MOP_Form with additional products

Please indicate the type of identification you are using to open your account: *

Driver License

State Issued ID

Passport

Upload copy of Driver's License:

Click or drag & drop image here to upload

We require the name listed on your account to match your social security card. *

By checking here, you are confirming this to be true. (If the name you entered does not match your social security card, please go back and make that change before proceeding.

Employer *

If you are currently not employed, please enter “Unemployed” or “Retired”.

Occupation *

Company Name *

If you are retired, please enter your occupation prior to retirement. If you are unemployed, please enter your most recent occupation.

Code Word

A code word is a verbal password that will be used any time you are speaking to a Success CU representative instead of verifying a social security number or other personal data.

If you would like to list beneficiaries for your membership savings, please provide the information requested below.

Name of Beneficiary 1:

Relationship or Social Security Number

Name of Beneficiary 2:

Relationship or Social Security Number

Your membership comes with a Success CU Checking account. There are no monthly maintenance fees for your new checking account.

Please check here if you do not wish to open a checking account.

If you would like to list beneficiaries for your checking account, please provide the information requested below.

Name of Beneficiary 1:

Relationship or Social Security Number

Name of Beneficiary 2:

Relationship or Social Security Number

Your Checking account comes with a debit card. Please indicate how you would like to receive your card:”

By Mail (10-14 days)

Pick up in a branch (we can print one for you in minutes by stopping into one of our branches! Account opening and document signing process must be complete prior to picking up your debit card.)

I prefer not to receive a debit card

Would you like Success CU to transfer from available funds in your savings account to pay overdraft items on your checking account? (PLEASE NOTE: An overdraft transfer fee may apply for this service. You can update your choice anytime by contacting the credit union.)

Yes

No

Success CU does NOT automatically pay overdrafts that occur from ATM withdrawals and everyday debit card transactions. If you would like us to, at our discretion, pay these items, please select “Opt In” below. Otherwise, select “Opt Out”. Overdraft charges may apply. See Regulation E Guidelines for more details.

Reg E Guidelines

Opt in

Opt out

I would like Success CU to provide me with direct deposit instructions for the following account(s):

Savings

Checking

Neither

Thank You