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Type of Membership:
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USA PATRIOT ACT INFORMATION
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.
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First Name*:
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Middle Name/Initial:
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Last Name*:
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What this means for you: When you open an account, we will ask for your name, address, date of birth, and other
information that will allow us to identify you. We may also ask to see your driver’s license or other identifying documents.
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Mother's Maiden Name*:
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SSN/TIN*:
Don't Have
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Date of Birth (MM/DD/YYYY)*:
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If no SSN/TIN please leave blank.
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Driver's License Number*:
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Issuing State*:
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Passport Country:
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You may enter your State ID or Passport Number. If passport Number
Select Passport as Issuing State.
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ID Expiration Date (MM/DD/YYYY)*:
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Gender:
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Occupation*:
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Membership Affiliation*:
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Please choose which Affiliation applies to your Membership.
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User Name*:
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Password*:
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Verify Password*:
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This is your Username and Password for our Online Home Banking System.
Passwords: are case sensitive; must not be the same as your username; must be between 8 and 20 characters long;
must contain at least 1 number; may contain only letters, numbers and these special characters !@#$%^&?*+=
The passwords entered do not match.
The passwords entered match.
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Address Type:
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Address Line 1*:
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Address Line 2:
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No P.O. Boxes Please
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City*:
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Country
State*:
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Zip Code*:
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Home Phone Number:
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Mobile Phone Number:
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Home Phone or Mobile Phone must be given.
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E-mail Address*:
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Verify E-mail Address*:
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The email addresses entered do not match.
The email addresses entered match.
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If your mailing address is different please check here.
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Address Type:
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Address Line 1*:
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Address Line 2:
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City*:
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Country
State*:
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Zip Code*:
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First Name*:
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Middle Name/Initial:
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Last Name*:
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Mother's Maiden Name*:
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SSN/TIN*:
Don't Have
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Date of Birth (MM/DD/YYYY)*:
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If no SSN/TIN please leave blank.
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Driver's License Number*:
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Issuing State*:
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Passport Country:
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You may enter your State ID or Passport Number. If passport Number
Select Passport as Issuing State.
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ID Expiration Date (MM/DD/YYYY)*:
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Gender:
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I am a U.S. Person (including a U.S. Resident Alien)
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Occupation*:
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Address Same as Primary
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Address Type:
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Address Line 1*:
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Address Line 2:
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No P.O. Boxes Please
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City*:
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Country
State*:
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Zip Code*:
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Home Phone Number:
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Mobile Phone Number:
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Home Phone or Mobile Phone must be given.
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E-mail Address*:
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Verify E-mail Address*:
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The email addresses entered do not match.
The email addresses entered match.
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If your mailing address is different please check here.
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Address Type:
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Address Line 1*:
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Address Line 2:
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City*:
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Country
State*:
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Zip Code*:
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Share Savings - Required for Membership
This basic Share is required with a minimum balance of $5.00
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Checking
Go Blue Checking is a simple checking account that's easy to maintain. There is no opening balance, no minimum balance requirement,
unlimited check writing privileges, and free access to our online Bill Pay.
There is no interest earned on Go Blue Checking.
Interest Checking guarantees you will make the most out of every dollar. You get unlimited check writing privileges
and free access to our online Bill Pay, while at the same time earning competitive interest rates that are calculated
daily and the interest will be credited into your account monthly and compounded monthly.
Requires a minimum balance of $500 to avoid $8 monthly maintenance fee.
Courtesy Pay covers life's unexpected emergencies and saves you from the merchant NSF fees, interruption of services
and the embarrassment and inconvenience associated with returned payments or declined transactions. You must check the box
below to have this service on your debit card.
Opt-in Notice and Disclosure
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Please add Courtesy Pay to my debit card.
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Check Card Design:
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Deliver Card To:
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Visa Credit Card(requires additional information.)
Amazingly low interest rate of only 8.99% Annual Percentage Rate. So if you carry a balance or
if you've been thinking about saving money by paying off those higher interest rate credit cards,
this is the card for you! Plus, we'll help you close out those higher interest rate credit cards
so you'll have one easy monthly payment.
Annual cash back bonus of 1.10% on purchases and a low interest rate of 12.99% Annual Percentage
Rate. This card provides the flexibility and rewards that you've been looking for!
No annual fees, fixed interest rate, at least 25 day grace
period, ATM access, overdraft option.
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Credit Card Design:
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Deliver Card To:
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Employment Status*:
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Start Date (MM/DD/YYYY)*:
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Employer*:
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Job Title*:
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Gross Monthly Income*: (12345.67)
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Work Address*:
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Work Phone*:
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Monthly Housing Cost*: (12345.67)
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No Joint
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Employment Status*:
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Start Date (MM/DD/YYYY)*:
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Employer*:
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Job Title*:
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Gross Monthly Income*: (12345.67)
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Work Address*:
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Work Phone*:
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Monthly Housing Cost*: (12345.67)
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