ATM/Debit Card Application

* Required Fields

ATM/Debit Policy

All ATM Deposits are unlimited and free
All transaction using POS(point of sale) and Visa(debit) purchases are free
Six free withdrawals or transfers per month at ATMs
The seventh and subsequent withdrawal from ATMs will cost $1.00 each and will be deducted from your account.
A 1% international service fee will be added to and listed separately on all transactions completed outside the United States
Never tell anyone your PIN(Personal Identification Number). Never write your PIN on your card. Never keep your PIN with your ATM Card
Card Replacement Fee (see ATM/Debit Replacement Fee under Our Rates and Services Charges.

Applicant

Account Number:

Name:

Street Address:

Apt.:

City:

State:

Zip Code:

Phone (best contact):

Co-Applicant

Name:

Address Same as Applicant:

Same Address

Street Address:

Apt.:

City:

State:

Zip Code:

Phone (best contact):

I/we authorize the credit union to perform a credit investigation, and I/we agree to be bound by all terms and conditions governing the use of the card as outlined in the ATM/Debit Policy and in the Electronic Funds Transfer Service Disclosuree that I/we will receive upon approval. I/we also understand that the credit union requires a signed application before any cards are ordered.

Security Code:

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