Sun East Federal Credit Union Membership Application

MEMBERSHIP APPLICATION
Sun East Federal Credit Union
PO Box 2231
Aston, PA 19014-0231

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Complete and return to Sun East Federal Credit Union with an initial share deposit of $5.00.
Notary is required. A copy of your driver’s license and a copy of the joint owner’s driver’s license must be included.

     I hereby make application for membership in the Sun East Federal Credit Union (SEFCU) and agree to subscribe and pay for at least one (1) share. I/we understand that by signing this card, I/we jointly and severally, agree to the terms of this Agreement, the Disclosure Of Account Terms and Fee schedule and SEFCU's bylaws and policy and any amendments thereto.
     The SEFCU is hereby authorized to recognize any of the signatures subscribed hereto in the payment of funds and/or the transaction of any business for this account, The joint owners of this account hereby agree with each other and with SEFCU that all sums now, heretofore or hereafter paid in as shares by any or all of the joint owners, to their credit as such joint owners with all accumulations thereon, are and shall be owned by them jointly, with right of survivorship and be subject to the withdrawal or receipt of any of them, and payment to any of them, or the survivor or survivors of them shall be valid and discharge SEFCU from any and all liability for any such payment.
     Any or all of the joint owners may pledge all or any part of the shares in this account as collateral security to a loan or loans from SEFCU.
     The right and authority of SEFCU under this agreement shall not be changed or terminated by the owner, or any of them except by written notice to SEFCU, which shall not affect transactions theretofore made. "If any sums due and owing by me are not paid (i.e. loan payments, fees and charges), the SEFCU is authorized by all joint owners to deduct the sums due of any portion thereof from this account and apply the same to any obligation of mine to SEFCU."
     "The SEFCU is hereby granted and reserves the right to investigate account history through an account verification service and refuse, limit, suspend or revoke any and all Credit Union services other than your share account, in the event that, in the Credit Union's sole judgment, an adverse credit history is discovered or for any other prudent business judgment reasons."
     If you are in default on a financial obligation to us, Federal law gives us the right to apply the balance of shares and dividends in your account(s) at the time of default to satisfy that obligation. Once you are in default, we may exercise this right without further notice.

Under penalties of perjury, I certify that:
1. The number shown on this form 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 that I am subject to backup withholding as a result of a failure to report all interest or dividends, or (c) the IRS has notified me that I am no longer subject to backup withholding.
3. I am a U.S. person (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 to avoid backup withholding.

Please note: Your signature must be notarized if not signed in the presence of a Sun East FCU representative.

MEMBER'S SIGNATURE	JOINT OWNER'S SIGNATURE
Driver's License #	Joint Owner's Driver's License #
CREDIT UNION USE ONLY Date ________________ OFFICER SIGNATURE	Joint Owner Social Security #

Last Name	First Name	Middle Name


Date of Birth month/day/year	Social Security # If club account, use tax ID
Email Address:		Telephone Number:	Work Number:
Mailing Address: (if listing a P.O. Box complete residence section) Street: Apt.# City State Zip	Residence Address: . Street: Apt.# City State Zip
Employer
Print Joint Owner's Name (if any) Joint Owner's Birthdate month/day/year	Joint Owner's Address: . Street: Apt.# City State Zip

Family Members: If you are joining the Credit Union through a family member, complete the section below by filling in the name, account number and relationship to this Credit Union member.
Name:	Account Number	Relationship: e.g. mother, brother, etc.