955 West Imperial Hwy., Ste. 100
P.O. Box 2400
Brea, CA 92822-2400
800.634.3228 714.671.5705 (International) Fax: 714.671.5775
Page 2 of 2 MS 11/2020
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APPLICATION AGREEMENT
5
STATEMENT OF FAITH
7
SIGNATURES
MEMBERSHIP AND ACCOUNT
APPLICATION
By consenting to this agreement, I agree to the terms and conditions which ECCU has adopted for each account and service established by me as stated in the ECCU
Account Agreement and Disclosures. I understand that a copy of ECCU’s Account Agreement and Disclosures will be delivered to the Primary Applicant after my account
is approved. I certify that the information furnished is complete and correct. ECCU may verify any of this information. In the event that this application is made with a
Joint Applicant(s), we understand that the use of the singular pronoun “I” applies to both Primary Applicant and Joint Applicant(s). I understand that from time to time,
ECCU may receive information from others, and ECCU will answer questions from others seeking the credit history of my account(s). I further understand that the
original or a copy of this application will be retained by ECCU even if service is not granted.
Notice to Primary Applicant (Member). I hereby apply for ECCU membership with this application and certify that I agree with ECCU’s Statement of Faith and qualify for
membership based on the relationship/ aliation indicated. I also understand that to continue my ECCU membership, I must maintain at least one of the relationships
established under this agreement or separately establish another nancial relationship (such as a savings, money market, or checking account) with the credit union
should I discontinue the relationship established under this agreement. I understand that, although my ability to join the credit union may be based on my place of
employment, continued membership and access to credit union services are not employment benets and may be provided or withheld based on credit union policies.
Membership Fee. I understand that ECCU will pay the credit union’s non-refundable membership fee of $5 once my application is approved.
Important Information for New Accounts. Federal law requires all nancial institutions to obtain, verify, and record information that identies each person who opens
an account. What this means for you: When you open an account, ECCU will ask for your name, address, date of birth, and other information that will allow us to identify
you.
Taxpayer Information. I understand that ECCU will report interest/dividends on all accounts to Federal and State Governments under the Social Security number of the
Primary Applicant.
Sending Agency Authorization (if applicable). I understand that my sending agency and its successors may from time to time receive information regarding my
account(s). I authorize my sending agency at its discretion to transfer funds into my account(s). This authorization will remain in eect until I notify ECCU in writing of its
termination.
Certication of U.S. Person. Under penalties of perjury, I, the Applicant, certify that: 1) The number shown on this application is my correct Taxpayer Identication
number and both my name and number are the same as on le with the Social Security Administration. 2) I am not subject to backup withholding either because: a) I am
exempt from backup withholding, or b) I have not been notied by the Internal Revenue Service (IRS) that I am subject to backup withholding, as a result of a failure to
report all interest or dividends, or c) The IRS has notied me that I am no longer subject to backup withholding. 3) I am a U.S. Person (including a U.S. Resident Alien), and
4) I am exempt from FATCA reporting.
Important certication instructions: If you are unable to certify that you are not subject to backup withholding, you must line out item (2) in the Certication above.
If you are subject to FATCA, cross out item (4) and complete a W-9
6
.
Certicate of Foreign Status. For income tax purposes, any individual who is not a U.S. Person or resident of the United States is a “Non-Resident Alien.” A Resident
Alien is an individual who meets either the “green card” test or “substantial presence” test. The green card test is simply whether the individual is a lawful permanent
resident of the United States at any time during the calendar year. To meet the substantial presence test, the individual must be physically present in the United States
at least 31 days during the current year and 183 days during the three-year period that includes the current year and two years immediately before that. If the individual
cannot meet either test, s/he would be considered a Non-Resident Alien. Certication of Non-Resident Alien. Under penalties of perjury, I, the Applicant, declare that
I have examined the information on this application and, to the best of my knowledge and belief, it is true, correct, and complete. I further certify under penalties of
perjury that: 1) I am the benecial owner (or am authorized to sign for the benecial owner) of all the income to which this application relates, 2) The benecial
owner is not a U.S. Person, 3) The income to which this application relates is not eectively connected with the conduct of a trade or business in the United States
or is eectively connected but is not subject to tax under an income tax treaty, and 4) For broker transactions or barter exchanges, the benecial owner is an
exempt foreign person.
Furthermore, I authorize this application to be provided to any withholding agent that has control, receipt, or custody of the income of which I am the benecial
owner or any withholding agent that can disburse or make payments of the income of which I am the benecial owner. I agree that I will submit a new form
within 30 days if any certication made on this form becomes incorrect. By signing below, I hereby apply for the account(s) and/or membership (as applicable), and
I acknowledge that I have read and agree to the “Application Agreement” and all certications within this agreement. The Internal Revenue Service does not require
your consent to any provision of this document other than certications required to avoid backup withholding, OR to establish your status as a foreign person
and, if applicable, obtain a reduced rate of withholding.
PASTOR MR. MRS. MS.
X
___________________________________________________________________________________________________ ________________________
PRIMARY APPLICANT (MEMBER’S) SIGNATURE DATE
PASTOR MR. MRS. MS.
X
___________________________________________________________________________________________________ ________________________
JOINT APPLICANT SIGNATURE DATE
1
Note to Non-Resident Aliens: If the Joint Applicant has a Social Security number or ITIN, s/he must apply as the Primary Applicant on this application.
2
ECCU will report interest/dividends on all accounts to Federal and State Governments under the Social Security number of the Primary Applicant.
3
Foreign Tax ID is now required. If your country does not issue a Tax ID number, you must write “Not Legally Required”.
4
This number is required if you are participating in ECCU’s promotional/referral programs
5
Must be 18 years or older. For fees and disclosures, refer to ECCU’s Personal Account Agreement and Disclosures and Account Information and Fee Schedule.
6
See http://www.irs.gov/pub/irs-pdf/fw9.pdf
ECCU has a statement of faith because agreement with these evangelical beliefs is a primary requirement to qualify for ECCU membership. Here is what we believe:
The Bible, consisting of all the books of the Old and New Testaments, is the inspired, only infallible, authoritative Word of God. The Scriptures of the Old
and New Testaments are without error or misstatement in their moral and spiritual teaching and record of historical facts. They are without error or defect of
any kind.
There is one God, eternally existent in three persons: Father, Son, and Holy Spirit.
We believe in the deity of our Lord Jesus Christ, in his virgin birth, his eternal, personal pre-existence, his sinless life, his miracles, his vicarious and atoning
death through his shed blood, his bodily resurrection, his ascension to the right hand of the Father, and his personal return in power and glory.
For the salvation of lost and sinful men, regeneration by the Holy Spirit is absolutely essential.
The present ministry of the Holy Spirit is to indwell and enable the Christian to live a godly life.
Resurrection is of both the saved and the lost; they that are saved unto the resurrection of life and they that are lost unto the resurrection of damnation.
We believe in the spiritual unity of believers in our Lord Jesus Christ.
