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Membership Application

Account Owner Information
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Services(s)
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Multiple Account Owner(s) Information
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Beneficiary/Payable on Death Payee Designation(s)
Tax Information Certification
By signing below, I certify under penalties of perjury that: (i) I am a US citizen or other US person, (ii) the Social Security Number (SSN)/Employer Identification Number (EIN) shown is my/the correct identification number and (iii) I am NOT, unless designated below, subject to backup withholding because I am exempt or I have not been notified by the IRS that I am subject to backup withholding as a result of a failure to report all dividends or interest, or because the IRS has notified me that I am no longer subject to backup withholding.


Finishing Up
Owner 1 is (or represents) a member, or applies for membership pursuant to the Old Hickory Credit Union's (referred to as "we", "us" and "our") bylaws, policies and this Contract. All owners, agents and information users (referred to as "you" and "your") request to open the account(s) and services selected on this Part 1 account form, and acknowledge receiving a copy of Part 2 of this Contract, which includes the Electronic Fund Transfer disclosures, Funds Availability disclosures, Privacy Policy and Rate and Fee disclosures. Part 2 of this Contract has been e-mailed to Owner 1 if an address was provided. You promise that the information provided in Part 1 is accurate, and that Part 1 has been completed according to your instructions, as confirmed by your signature(s) below or by using an account or service. You agree an owner may conduct transactions and initiate, open, change, add, close or terminate accounts and services, a signer may conduct transactions on accounts, and an information use may access account and service information, as explained in Part 2 of this Contract. You agree we may obtain and use credit and account reports to verify your eligibility for accounts and services we offer. You understand this Contract governs all your accounts and services with us, and agree that we may rely exclusively on this Contract and have no obligation to rely on any other documents. You agree we may change this Contract from time to time, and that such changes are binding on you. You understand you may obtain a copy of this Contract from us during business hours (and Part 2 from our website at any time), and may initiate, change, add, close or terminate an account, service or membership at any time according to this Contract. By signing below, using an account or service, or receipt or availability of a statement, you agree to this Contract (Parts 1 and 2). The IRS does not require your consent to any provision of this Contract other than the certification required to avoid backup withholding (in Section 8 above).
Electronic Signature and Acknowledgement

 

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