• • • •
•
Already a CAP COM Member? Enroll in our School Banking Program! Call (518) 458-2195, send an e-mail to schoolbanking@capcomfcu.org or stop in any location and tell us your participating school’s name. Not a CAP COM Member? It’s easy to get a School Banker started with a new Youth Account! • Complete a Youth Membership Application. • Call (518) 458-2195 or send an e-mail to schoolbanking@capcomfcu.org. • Visit www.capcomfcu.org. • Ask at any branch location.
City
City
State
State
Zip Code Social Security Number Zip Code
Albany • Brunswick • Clifton Park Cohoes • Colonie • Glenmont • Glens Falls Latham • Niskayuna • North Greenbush
Date of Birth
Date of Birth
call Carie Sala today at (518) 458-2195 ext. 3671 or send an e-mail to csala@capcomfcu.org.
REV 9/2011
Joint Owner’s Name: (must be notarized or witnessed by a CAP COM Employee)
Under penalties of perjury, I certify: (1) that the number shown on this form is my correct Taxpayer Identification number, (2) that 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); and (3) that I am a U.S. person (including a U.S. Resident Alien).
Youth’s Name/Signature: Joint Owner’s Signature:
(Note: any future products or services established on this account are the responsibility of all parties. We require a youth’s account to be opened with a joint owner at least 18 years of age.)
Credit pulled Approved
OFAC Date
PreApp Account Number
TIS Disc
Office Use Only Chex ID copied
TO OPEN/CHANGE AN ACCOUNT, AT CAP COM FCU, YOUR SIGNATURE MUST BE NOTARIZED: The above signature was notarized in the State of ________________County of ___________________this ____Day of ___________, Year ________. Before me personally came to me known and known to me to be the individual described in and who executed the attached instrument, and he/she duly acknowledged that he/she executed the same. NOTARY PUBLIC:
TO OPEN/CHANGE AN ACCOUNT, AT CAP COM FCU, YOUR SIGNATURE MUST BE NOTARIZED: The above signature was notarized in the State of ________________County of ___________________this ____Day of ___________, Year ________. Before me personally came to me known and known to me to be the individual described in and who executed the attached instrument, and he/she duly acknowledged that he/she executed the same. NOTARY PUBLIC:
CAP COM FCU is federally insured by the National Credit Union Administration.
www.capcomfcu.org To sign up your school
Social Security Number
Beneficiary Designation – Payable on Death All living joint owners/members on Account supersede beneficiaries.
Main Office & Mailing Address 18 Computer Drive East • Albany, NY 12205
The Internal Revenue Service does not require your consent to any provisions of this document other than the certification required to avoid backup withholding.
•
Phone Numbers & Website CCFCU Phone (518) 458-2195 CCFCU Toll Free (800) 468-5500 CCFCU Fax (518) 458-2261 Touch-24 (518) 458-8986 Touch-24 Toll Free (800) 634-2340 Connect-24 & Mobile Banking www.capcomfcu.org I hereby apply for membership at CAP COM FCU. I agree to conform to its laws and amendments thereof and subscribe for at least one share. I also agree to the terms and conditions of any account that I have at the Credit Union, now or in the future and agree that the terms and conditions may change from time to time. Statutory Lien Notice – Except as otherwise provided by federal law, CAP COM FCU has the right to impress and enforce a statutory lien against a member’s shares and dividends in the event the member fails to satisfy a financial obligation to the Credit Union. The Credit Union has the authority to enforce this statutory lien right without further notice to the member. A member’s financial obligations include, but are not limited to, outstanding loan balances, NSF (insufficient funds) checks and related fees. If more than one beneficiary is named, proceeds will be equally distributed. The named beneficiaries can only be changed by written authorization signed by all account owners. My signature below is evidence that everything stated is correct to the best of my knowledge. My signature also authorizes CAP COM FCU to obtain a consumer credit report in connection with this process and for any update, renewal, or extension of credit received; and at my request, the Credit Union will supply me with the name and address of any credit bureau from which it will receive, or has received, a consumer report on me. I am aware that completion of this membership application is not to be considered as an application for credit. Agreement: CAP COM FCU is hereby authorized to recognize any of the signatures subscribed hereto in the payment of funds or the transaction of any business for this account. The joint owners of this account hereby agree with each other and with CAP COM FCU that all sums now paid in on shares, or heretofore or hereafter paid on shares by any or all of the joint owners to their credit as such joint owners with all accumulation thereon, are and shall be owned by them jointly, with the 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 shall be valid and discharge CAP COM FCU from any liability for such payment. You have read the agreement for each service for which you have applied. By signing below you acknowledge receipt and agree to be bound by the terms of the agreement for each service checked on the front of this application.
Address
Beneficiary/Payee
Address
Beneficiary/Payee
Mortgage Solutions
• Kids earn up to $70 per year* with our Great Grades and Reading Programs.
• Special-rate CertifiKIDs** in 18- and 36-month terms let your child’s money grow faster!
• Open an account with just $1. Make weekly deposits at your school or any CAP COM location! The more you save, the more you can win with fun incentives.
*See website or ask an associate for additional details, current rates and disclosure information. ** Certificate requires membership in the Credit Union. Certificate dividends are compounded daily and posted quarterly. A penalty may be imposed for early withdrawals. Fees and other conditions may reduce the earnings on some accounts. Other rates and terms may apply based on product/service relationship with the Credit Union.
Home Phone Number
Social Security Number
Adult: S
Rent
State
Please complete both pages Page 1 of 2
I authorize CAP COM FCU to establish or add the following accounts/services: Holiday Club Members Choice Club Money Managers Club College Savings Club
Employer Address
Employer Name
E-mail Address:
State
Issue Date*
State*
Driver’s License Number* *Required to process application.
Date of Birth Work Phone Number
City
Live with others How long?
City
First Name
Home Phone Number
Social Security Number
Own
Address
Zip Code
Expiration Date*
Zip Code
Name your own club
Zip Code
REV 9/2011
Town of Green Island Middle Name
I have included a copy of a valid ID. A Joint Member is an individual who has: established membership with CAP COM FCU and, if qualified, is eligible for all products and services. eligibility: employer relative (name) (relationship) lives, works, worships or attends school in the State of New York, City of: (please circle one) Albany Cohoes Mechanicville Rensselaer Schenectady Troy Watervliet
Joint Member (Must be at least 18 years old.)
T-Shirt Size (Circle only one): Youth: S M L
Date of Birth
State
Middle Name
Mother’s maiden name or word to be used as a“lock warning/security” code
City
First Name
I have included my $1 initial deposit. School Banking Program at: (school name) Grade Employer Relative Name of Relative_______________________________ Relationship__________________________ Lives, works, worships or attends school in the State of New York, City of: (please circle one) Albany Cohoes Mechanicville Rensselaer Schenectady Troy Watervliet Town of Green Island
• FREE Coin Machines! Turn change into cash at any CAP COM branch! Madison and Jeffrey Clermont, of Watervliet Elementary.
Last Name
School Banking features
E-mail Address
It’s easy to get started! Complete the attached application or see the back panel to learn how to open up an account or sign your school up today!
Address
• Switch Kits to get you started. We’ll transfer and close your old account for you!
We’re teaching kids at dozens of local schools how to save!
Last Name
School Banking helps kids learn to save by making deposits at school. We partner with more than 40 local schools to offer special visits, online account access and more!
Eligibility Or Or
Banking
Youth Membership Application
$chool Become a School Banking partner today!
• • • •
•
Already a CAP COM Member? Enroll in our School Banking Program! Call (518) 458-2195, send an e-mail to schoolbanking@capcomfcu.org or stop in any location and tell us your participating school’s name. Not a CAP COM Member? It’s easy to get a School Banker started with a new Youth Account! • Complete a Youth Membership Application. • Call (518) 458-2195 or send an e-mail to schoolbanking@capcomfcu.org. • Visit www.capcomfcu.org. • Ask at any branch location.
City
City
State
State
Zip Code Social Security Number Zip Code
Albany • Brunswick • Clifton Park Cohoes • Colonie • Glenmont • Glens Falls Latham • Niskayuna • North Greenbush
Date of Birth
Date of Birth
call Carie Sala today at (518) 458-2195 ext. 3671 or send an e-mail to csala@capcomfcu.org.
REV 9/2011
Joint Owner’s Name: (must be notarized or witnessed by a CAP COM Employee)
Under penalties of perjury, I certify: (1) that the number shown on this form is my correct Taxpayer Identification number, (2) that 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); and (3) that I am a U.S. person (including a U.S. Resident Alien).
Youth’s Name/Signature: Joint Owner’s Signature:
(Note: any future products or services established on this account are the responsibility of all parties. We require a youth’s account to be opened with a joint owner at least 18 years of age.)
Credit pulled Approved
OFAC Date
PreApp Account Number
TIS Disc
Office Use Only Chex ID copied
TO OPEN/CHANGE AN ACCOUNT, AT CAP COM FCU, YOUR SIGNATURE MUST BE NOTARIZED: The above signature was notarized in the State of ________________County of ___________________this ____Day of ___________, Year ________. Before me personally came to me known and known to me to be the individual described in and who executed the attached instrument, and he/she duly acknowledged that he/she executed the same. NOTARY PUBLIC:
TO OPEN/CHANGE AN ACCOUNT, AT CAP COM FCU, YOUR SIGNATURE MUST BE NOTARIZED: The above signature was notarized in the State of ________________County of ___________________this ____Day of ___________, Year ________. Before me personally came to me known and known to me to be the individual described in and who executed the attached instrument, and he/she duly acknowledged that he/she executed the same. NOTARY PUBLIC:
CAP COM FCU is federally insured by the National Credit Union Administration.
www.capcomfcu.org To sign up your school
Social Security Number
Beneficiary Designation – Payable on Death All living joint owners/members on Account supersede beneficiaries.
Main Office & Mailing Address 18 Computer Drive East • Albany, NY 12205
The Internal Revenue Service does not require your consent to any provisions of this document other than the certification required to avoid backup withholding.
•
Phone Numbers & Website CCFCU Phone (518) 458-2195 CCFCU Toll Free (800) 468-5500 CCFCU Fax (518) 458-2261 Touch-24 (518) 458-8986 Touch-24 Toll Free (800) 634-2340 Connect-24 & Mobile Banking www.capcomfcu.org I hereby apply for membership at CAP COM FCU. I agree to conform to its laws and amendments thereof and subscribe for at least one share. I also agree to the terms and conditions of any account that I have at the Credit Union, now or in the future and agree that the terms and conditions may change from time to time. Statutory Lien Notice – Except as otherwise provided by federal law, CAP COM FCU has the right to impress and enforce a statutory lien against a member’s shares and dividends in the event the member fails to satisfy a financial obligation to the Credit Union. The Credit Union has the authority to enforce this statutory lien right without further notice to the member. A member’s financial obligations include, but are not limited to, outstanding loan balances, NSF (insufficient funds) checks and related fees. If more than one beneficiary is named, proceeds will be equally distributed. The named beneficiaries can only be changed by written authorization signed by all account owners. My signature below is evidence that everything stated is correct to the best of my knowledge. My signature also authorizes CAP COM FCU to obtain a consumer credit report in connection with this process and for any update, renewal, or extension of credit received; and at my request, the Credit Union will supply me with the name and address of any credit bureau from which it will receive, or has received, a consumer report on me. I am aware that completion of this membership application is not to be considered as an application for credit. Agreement: CAP COM FCU is hereby authorized to recognize any of the signatures subscribed hereto in the payment of funds or the transaction of any business for this account. The joint owners of this account hereby agree with each other and with CAP COM FCU that all sums now paid in on shares, or heretofore or hereafter paid on shares by any or all of the joint owners to their credit as such joint owners with all accumulation thereon, are and shall be owned by them jointly, with the 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 shall be valid and discharge CAP COM FCU from any liability for such payment. You have read the agreement for each service for which you have applied. By signing below you acknowledge receipt and agree to be bound by the terms of the agreement for each service checked on the front of this application.
Address
Beneficiary/Payee
Address
Beneficiary/Payee
Mortgage Solutions
$chool Banking
School Banking helps kids learn to save by making deposits at school. We partner with more than 40 local schools to offer special visits, online account access and more!
It’s easy to get started! Complete the attached application or see the back panel to learn how to open up an account or sign your school up today!
School Banking features
• Switch Kits to get you started. We’ll transfer and close your old account for you!
• Kids earn up to $70 per year* with our Great Grades and Reading Programs.
• Special-rate CertifiKIDs** in 18- and 36-month terms let your child’s money grow faster!
• Open an account with just $1. Make weekly deposits at your school or any CAP COM location! The more you save, the more you can win with fun incentives.
• FREE Coin Machines! Turn change into cash at any CAP COM branch!
*See website or ask an associate for additional details, current rates and disclosure information. ** Certificate requires membership in the Credit Union. Certificate dividends are compounded daily and posted quarterly. A penalty may be imposed for early withdrawals. Fees and other conditions may reduce the earnings on some accounts. Other rates and terms may apply based on product/service relationship with the Credit Union.
Become a School Banking partner today!
We’re teaching kids at dozens of local schools how to save!
Madison and Jeffrey Clermont, of Watervliet Elementary.
Youth Membership Application Eligibility Or Or
I have included my $1 initial deposit. School Banking Program at: (school name) Grade Employer Relative Name of Relative_______________________________ Relationship__________________________ Lives, works, worships or attends school in the State of New York, City of: (please circle one) Albany Cohoes Mechanicville Rensselaer Schenectady Troy Watervliet Town of Green Island
Last Name
First Name
Address
Middle Name
City
State
Social Security Number
Zip Code
Date of Birth
Home Phone Number E-mail Address
Mother’s maiden name or word to be used as a“lock warning/security” code
T-Shirt Size (Circle only one): Youth: S M L
Adult: S
Joint Member (Must be at least 18 years old.) I have included a copy of a valid ID. A Joint Member is an individual who has: established membership with CAP COM FCU and, if qualified, is eligible for all products and services. eligibility: employer relative (name) (relationship) lives, works, worships or attends school in the State of New York, City of: (please circle one) Albany Cohoes Mechanicville Rensselaer Schenectady Troy Watervliet Last Name
First Name
Address Own
Middle Name
City Rent
Town of Green Island
State
Zip Code
Live with others How long?
Social Security Number
Date of Birth
Home Phone Number
Work Phone Number
Driver’s License Number* *Required to process application.
State*
Issue Date*
Expiration Date*
E-mail Address: Employer Name Employer Address
City
State
I authorize CAP COM FCU to establish or add the following accounts/services: Holiday Club Members Choice Club Money Managers Club College Savings Club
Please complete both pages Page 1 of 2
Zip Code
Name your own club
REV 9/2011
CAP COM FCU is federally insured by the National Credit Union Administration.
REV 9/2011
Albany • Brunswick • Clifton Park Cohoes • Colonie • Glenmont • Glens Falls Latham • Niskayuna • North Greenbush
call Carie Sala today at (518) 458-2195 ext. 3671 or send an e-mail to csala@capcomfcu.org.
To sign up your school
Not a CAP COM Member? It’s easy to get a School Banker started with a new Youth Account! • Complete a Youth Membership Application. • Call (518) 458-2195 or send an e-mail to schoolbanking@capcomfcu.org. • Visit www.capcomfcu.org. • Ask at any branch location.
Already a CAP COM Member? Enroll in our School Banking Program! Call (518) 458-2195, send an e-mail to schoolbanking@capcomfcu.org or stop in any location and tell us your participating school’s name.
Main Office & Mailing Address 18 Computer Drive East • Albany, NY 12205
Phone Numbers & Website CCFCU Phone (518) 458-2195 CCFCU Toll Free (800) 468-5500 CCFCU Fax (518) 458-2261 Touch-24 (518) 458-8986 Touch-24 Toll Free (800) 634-2340 Connect-24 & Mobile Banking www.capcomfcu.org
www.capcomfcu.org
Mortgage Solutions
Beneficiary Designation – Payable on Death All living joint owners/members on Account supersede beneficiaries.
Beneficiary/Payee
Social Security Number
Address
City
State
Beneficiary/Payee
• • •
•
•
Date of Birth
Social Security Number
Address •
Zip Code
City
State
Zip Code
Date of Birth
I hereby apply for membership at CAP COM FCU. I agree to conform to its laws and amendments thereof and subscribe for at least one share. I also agree to the terms and conditions of any account that I have at the Credit Union, now or in the future and agree that the terms and conditions may change from time to time. Statutory Lien Notice – Except as otherwise provided by federal law, CAP COM FCU has the right to impress and enforce a statutory lien against a member’s shares and dividends in the event the member fails to satisfy a financial obligation to the Credit Union. The Credit Union has the authority to enforce this statutory lien right without further notice to the member. A member’s financial obligations include, but are not limited to, outstanding loan balances, NSF (insufficient funds) checks and related fees. If more than one beneficiary is named, proceeds will be equally distributed. The named beneficiaries can only be changed by written authorization signed by all account owners. My signature below is evidence that everything stated is correct to the best of my knowledge. My signature also authorizes CAP COM FCU to obtain a consumer credit report in connection with this process and for any update, renewal, or extension of credit received; and at my request, the Credit Union will supply me with the name and address of any credit bureau from which it will receive, or has received, a consumer report on me. I am aware that completion of this membership application is not to be considered as an application for credit. Agreement: CAP COM FCU is hereby authorized to recognize any of the signatures subscribed hereto in the payment of funds or the transaction of any business for this account. The joint owners of this account hereby agree with each other and with CAP COM FCU that all sums now paid in on shares, or heretofore or hereafter paid on shares by any or all of the joint owners to their credit as such joint owners with all accumulation thereon, are and shall be owned by them jointly, with the 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 shall be valid and discharge CAP COM FCU from any liability for such payment. You have read the agreement for each service for which you have applied. By signing below you acknowledge receipt and agree to be bound by the terms of the agreement for each service checked on the front of this application.
The Internal Revenue Service does not require your consent to any provisions of this document other than the certification required to avoid backup withholding. Under penalties of perjury, I certify: (1) that the number shown on this form is my correct Taxpayer Identification number, (2) that 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); and (3) that I am a U.S. person (including a U.S. Resident Alien).
Youth’s Name/Signature:
Joint Owner’s Name:
Joint Owner’s Signature:
(must be notarized or witnessed by a CAP COM Employee)
(Note: any future products or services established on this account are the responsibility of all parties. We require a youth’s account to be opened with a joint owner at least 18 years of age.)
TO OPEN/CHANGE AN ACCOUNT, AT CAP COM FCU, YOUR SIGNATURE MUST BE NOTARIZED: The above signature was notarized in the State of ________________County of ___________________this ____Day of ___________, Year ________. Before me personally came to me known and known to me to be the individual described in and who executed the attached instrument, and he/she duly acknowledged that he/she executed the same. NOTARY PUBLIC: TO OPEN/CHANGE AN ACCOUNT, AT CAP COM FCU, YOUR SIGNATURE MUST BE NOTARIZED: The above signature was notarized in the State of ________________County of ___________________this ____Day of ___________, Year ________. Before me personally came to me known and known to me to be the individual described in and who executed the attached instrument, and he/she duly acknowledged that he/she executed the same. NOTARY PUBLIC: Credit pulled Approved
OFAC Date
PreApp Account Number
TIS Disc
Office Use Only Chex ID copied