1325 Oxford Drive Allentown, PA 18103
(610) 791-2464 Fax (610) 791-2900
MEMBERSHIP APPLICATION
Yes!
I want to become a member. I will enclose my minimum opening deposit of $5.25 (your first share plus a $.25 one-time
non-refundable fee) and a copy of my driver’s license. Sign me up for: Share Draft Direct Deposit Payroll Deduction
MEMBERSHIP FORM ACCT #
Primary Name (Please Print) Driver’s License #
Home Address: Street City State Zip Years at present address
Previous home address (if less than five years):
Street City State Zip
Phone (H) (W)
Date of Birth Social Security No.
Employer # yrs. Mother’
s Maiden Name
I hereby make application for membership in AME FEDERAL CREDIT UNION and agree to conform to its bylaws and amendments thereof and subscribe for at least one share. I
have received disclosure for any Credit Union accounts I now have and agree to the terms and conditions set forth for those and any future accounts. I also agree the Credit Union
may change these terms and conditions from time to time. This account may not be pledged, transferred, or assigned to any party other than the Credit Union.
I am within the Credit Union’s field of membership as an employee of:
Or as a family member of: Relationship
JOINT SHARE ACCOUNT AGREEMENT • NOT TRANSFERRABLE For Primary Share (Savings) Account Only
AME Federal Credit Union is hereby authorized to recognize any of the signatures subscribed below 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 said credit union that all sums now paid in on shares, or heretofore or hereafter paid in on shares by any or all of
said joint owners to their credit as such joint owners with all accumulations thereon, are and shall be owned by them jointly, with right of survivorship and be subject to the with-
drawal or receipt of any of them, and payment to any of them or the survivor or survivors shall be valid and discharge said credit union from any liability for such payment. The joint
owners also agree to the terms and conditions of the account as established by the credit union from time to time. Any or all of said joint owners may pledge all or any part of the
shares in this account as collateral security to a loan or loans from the credit union. The right or authority of the credit union under this agreement shall not be changed or terminat-
ed by said owners, or any of them except by written notice to said credit union which shall not affect transactions theretofore made.
Taxpayer Certification
Under penalty of perjury, I certify (1) that the number shown on this card is my correct taxpayer identification number and (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 a failure to report all interest or dividends, or the Internal Revenue Service has notified me
that I am no longer subject to backup withholding.
New Member signature
Joint Owner’s Signature
Joint Owner (Please print) Driver’s License #
Home Address: Street City State Zip Years at present address
Previous home address (if less than five years):
Street City State Zip
Phone (H) (W)
Date of Birth Social Security No.
Employer # yrs. Mother’s Maiden Name
Please order basic checks
Send me more information on: Personal Loan VISA Check Card Auto Loan Mastercar
d
Home Equity Loans Home Banking Direct Deposit Payroll Deductions Other:
I (We) authorize the Credit Union to obtain credit reports in connection with this application for credit and for any update, renewal or extensions of the credit received.
Applicant Signature Date
Joint Applicant Signature Date
All applications subject to eligibility and credit union approval.
This application appr
oved on: Date Membership Officer
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