APPLICATION FOR FIELD OF MEMBERSHIP AMENDMENT
NCUA FORM 4015-EZ
USE FOR MULTIPLE COMMON BOND EXPANSIONS OF LESS THAN 3,000
PERSONS AND ALL SINGLE COMMON BOND EXPANSIONS
Attach a separate application for each group included in your request for expansion.
The application must be complete or it will be returned unprocessed.
1. Name RIFUHGLWXQLRQ
$ddress of credit union:
Telephone Number:
Charter Number:
2. Name and address of group:
Telephone Number:
If the group is an association, include a copy of the association’s
Charter/Bylaws or other equivalent organizational documentation.
3. Provide the proposed field of membership wording:
4. Multiple Common Bond Expansions Only: Attach a letter, or equivalent
documentation, from the group requesting credit union service indicating:
that the group wants to be added to the federal credit union’s field of membership;
the number of persons to be added and the group’s location(s); and
the group’s distance to the credit union’s nearest service facility.
5. Single Common Bond Expansions Only: How the group shares the occupational
or associational common bond
NCUA 4015-EZ PAGE 1
