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Membership Application

Sikorsky Financial Credit Union
1000 Oronoque Lane
Stratford, CT 06614
203-377-2252, Option 4
888-753-5553, Option 4
Fax 203-378-7214

Important Information About Procedures for Opening a New Account
To help the government fight the funding of terrorism and money laundering activities, federal law requires all financial institutions to obtain, verify and record information that identifies each person who opens an account.

Please complete and submit this application, which will start the membership process. In addition, it is required that you print out this application, sign it and mail with a check for a minimum of $5.00 or bring in to any of our branches. Opening and maintaining a $5 regular savings account is a requirement to become a member-owner. It represents your share of Sikorsky Financial Credit Union! All transactions are secure.

Required fields are marked with an asterisk (*).

Membership

Please tell us how you heard about us

What is your eligibility of Membership*

I live in New Haven, Fairfield or Hartford County.
I work in New Haven, Fairfield or Hartford County.
I worship in New Haven, Fairfield or Hartford County.
I volunteer in New Haven, Fairfield or Hartford County.
I am an immediate family member of an existing Sikorsky Financial Credit Union member.
I am a household member of an existing Sikorsky Financial Credit Union member.

Member Information
First Name * Middle Initial
Last Name * Social Security Number *
Home Phone * Cell Phone
Email Address
Mother's Maiden Name * Date of Birth *
mm/dd/yyyy
Driver's License Driver License State
Driver's License State (Non-US Addresses)  
 
Yes No
Employer Name * Work Phone *
 
Residence Address * Years at Current Address *
 
City * State/Province *
State (Non-US Addresses) *  
 
ZIP/Postal Code * Country *
   
Mailing Address (if different)
 
 
City State/Province
State (Non-US Addresses) *  
 
ZIP/Postal Code Country
Previous Address (if less than 2 years)*  
 
 
City* State/Province*
State (Non-US Addresses) *  
 
ZIP/Postal Code * Country *
 
Click to add a Joint Owner (if applicable)  
First Name * Middle Initial
Last Name * Social Security Number *
Home Phone * Cell Phone
Work Phone
Date of Birth * Email Address
mm/dd/yyyy
Driver's License Driver License State
Driver's License State (Non-US Addresses)  
 
Residence Address *  
 
 
City * State/Province *
State (Non-US Addresses) *  
 
ZIP/Postal Code * Country *
 
Click to add an Additional Joint Owner (if applicable)  
First Name * Middle Initial
Last Name * Social Security Number *
Home Phone * Cell Phone
Work Phone
Date of Birth * Email Address
mm/dd/yyyy
Driver's License Driver License State
Driver's License State (Non-US Addresses)  
 
Residence Address *  
 
 
City * State/Province *
State (Non-US Addresses) *  
 
ZIP/Postal Code * Country *
 
Account Information
Initial Deposit Amount*  

Regular Savings

If you wish to open additional accounts (checking, share certificates, etc.), please fill out an additional application.

I/we request the following eServices

Telephone Banking (CALL-24)
Online Banking

All new accounts are verified through ChexSystems.


Disclosures *

I hereby make application for membership at Sikorsky Financial Credit Union and agree to conform to its bylaws and amendments thereof and subscribe for at least one share (represented by my $5 minimum deposit which I will maintain at all times). I also certify that I am eligible for membership as it is defined in the Sikorsky Financial Credit Union charter and bylaws.

The following documents may be read and/or printed online by clicking on the links below. Printed copy of these documents will be sent to you upon our opening of your account(s).

Member Share Account Contract
Funds Availability Policy
Electronic Fund Transfer Agreement
Privacy Policy
Schedule of Charges


By signing this application each of you jointly and severally agrees to the terms and conditions contained in the above documents.

 

Under penalties of perjury, I certify that:

  Applicant Joint Owner Additional Owner
The number shown on this form is my correct Taxpayer Identification Number. * Yes No Yes No Yes No
I am not subject to backup withholding either because I have not been notified that I am subject to backup withholding as a result of failure to report all interest or dividends, or the Internal Revenue Service has notified me that I am no longer subject to backup withholding. * Yes No Yes No Yes No
I am a U.S person (including a U.S. Resident Alien). * Yes No Yes No Yes No

The Internal Revenue Service does not require your consent to any provision of this document other than the certifications required to avoid backup withholding.


Signatures - this document must be printed and signed in the box(es) below and mailed to the address above or brought into any branch along with your deposit.

     
Member Signature Joint Owner Signature Joint Owner Signature

April 16, 2014
21:06 PM PST