Youth Savings Account Application

Youth Account Application

Primary Owner - Youth

First Name *

Last Name *

Date of Birth *

Social Security Number *

Email Address

Phone Number *

Mother's Maiden Name *

We use a 'Code Word' for identification purposes. Choose a security word that you will remember:

Code Word

Home Address

Street Address *

City *

ZIP Code *

Mailing Address (If different from above)

Street Address

City

Enter ZIP Code

Membership Eligibility

Member or student of an Anabaptist church or organization

I am a relative of an Everence member

Shared Values - Agree to Psalm 24: "All I am and all I have are from God."

Please enter the church or organization name if applicable:

Church or Organization Name

Please enter the name of your relative that is an Everence member if applicable:

Relative Name

If a licensed driver, please upload a copy of your driver's license:

Upload File - Acceptable formats are .pdf, .docx, .doc, .odt, .rtf, .txt. The maximum size of the uploaded file is 3 megabytes (3mb)

Click or drag & drop file here to upload

Upload Image - Acceptable formats are .png, .jpg, .jpeg. The maximum size of the uploaded file is 3 megabytes (3mb).

Click or drag & drop image here to upload

Joint Owner Name - Parent / Grandparent / Guardian

First Name *

Last Name *

Date of Birth *

Social Security Number *

Email Address

Enter home address if different than youth:

Street Address

City

ZIP Code

Phone Number *

Mother's Maiden Name *

Code Word

Relationship to the primary owner *

Please upload a copy of your valid Photo ID / Driver's License.*

Upload File. Acceptable formats are .pdf, .docx, .doc, .odt, .rtf, .txt. The maximum size of the uploaded file is 3 megabytes (3mb)

Click or drag & drop file here to upload

Upload Image. Acceptable formats are .png, .jpg, .jpeg. The maximum size of the uploaded file is 3 megabytes (3mb). *

Click or drag & drop image here to upload

Additional Joint Owner Name

First Name

Last Name

Date of Birth

Social Security Number

Email Address

Enter address only if different from child

Street Address

City

ZIP Code

Phone Number

Mother's Maiden Name

Code Word

Relationship to the primary owner

Photo ID / Driver's License upload

Upload File. Acceptable formats are .pdf, .docx, .doc, .odt, .rtf, .txt. The maximum size of the uploaded file is 3 megabytes (3mb)

Click or drag & drop file here to upload

Upload Image. Acceptable formats are .png, .jpg, .jpeg. The maximum size of the uploaded file is 3 megabytes (3mb).

Click or drag & drop image here to upload

Additional accounts/debit card (optional)

A minimum of $5.00 is required to open your membership with Everence FCU (deposited into your regular savings account). Certain accounts require additional initial deposits or minimum balance requirements. Please be sure to add these amounts to the initial funding of your account to avoid any fees.

Indicate which accounts you wish to open (In order to open a debit card you must have a checking account).

Youth Savings Account - $5.00 initial deposit required.

Regular Checking - $25.00 initial deposit and joint adult owner required.

Debit Card - joint adult owner required.

If applying for a debit card, I request the Everence Federal Credit Union Mastercard debit/ATM card be issued in my name and in the name of the co-applicant (if applicable). Further, I acknowledge that I have received a copy of the Mastercard debit/ATM card cardholder agreement and that I have read, understand, and agree to be legally bound by the terms and conditions of that agreement. I also acknowledge receipt of the disclosure statement informing me of my rights under the Electronic Funds Transfer Act and Truth-in Savings Act as applicable.

Debit Card Agreement & Disclosure Statement

Member service questionnaire - personal checking account

If you are adding a checking account or money market account please complete the questionnaire below.Label

Citizenship (check one)

U.S. citizen

Resident alien

Nonresident alien

If non-U.S. citizen, country of citizenship

Will you be using our wire services regularly? (Check all that apply)

Domestic wires more than 5 times a month

International wires more than 5 times a month

Will you have any large cash needs over $5000 on a regular basis? (Check one)

Yes

No

How many times a month do you anticipate you will be using the ATM? (Check one)Radio Label

Less than 25 times per month

More than 25 times per month

How many checks do you anticipate writing each month? (Check one)

0 - 50

51 - 100

More than 100

Will you be purchasing money orders more than 5 times a month? (Check one)

Yes

No

Disclosures

This electronic submission qualifies as my signature. I understand that I may have to sign additional documents before my new membership will be processed.

I understand that by clicking on the I AGREE button immediately following this notice, I am providing 'written instructions' to Everence Federal Credit Union under the Fair Credit Reporting Act authorizing Everence Federal Credit Union to obtain information from my personal credit profile or information from Experian or others, including but not limited to verifying my identity and performing authentications as required by applicable local, state, and federal regulations. I authorize Everence Federal Credit Union to obtain such information solely for membership opening with Everence Federal Credit Union.

By submitting this application electronically and clicking “I AGREE” below, I acknowledge that I have read and accepted the terms and conditions of Everence Federal Credit Union’s MEMBERSHIP DISCLOSURE, DEPOSIT RATES, FEE SCHEDULE, and PRIVACY NOTICE. All joint applicants (where applicable) have also agreed to the terms and conditions above and authorized the submission of this application.

Membership Disclosure

Deposit Rates

Fee Schedule

Privacy Notice

Certification, backup withholding information: By clicking “I AGREE” below, I certify that:

1. The Social Security Number I provide on this application is my correct taxpayer identification number (or I am waiting for a number to be issued to me), and

2. I am not subject to backup withholding because: (a) I am exempt from backup withholding, or (b) I have not been notified by the Internal Revenue Service (IRS) that I am subject to backup withholding as a result of failure to report all interest or dividends, or (c) the IRS has notified me that I am no longer subject to backup withholding, and

3. I am a U.S. person (including a U.S. resident alien).

If you answer no to any of the above statements please contact the credit union at 800-451-5719 for an alternative application.

I authorize Everence Federal Credit Union to obtain my credit report and process this application for credit union membership.

I AGREE

Thank you for applying! Someone from our team will contact you within one business day to provide the account number so you can make a deposit.