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PREMIUM ONLINE SAVINGS ACCOUNT

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Form 220 (09/21) © Pentagon Federal Credit Union, 2021 Page 1 of 3
c
 
New Membership & Premium Online Savings Account
: Complete All Sections. 
c
 
Open Secondary
Premium Online Savings
Account
: Complete Sections 1, 2 & 6.  
c
 
Update Premium Online Savings Account Information
: Complete Sections 1, 2 & 6. 
Account Number: 
____________________________________________________
• If you are removing a joint owner from an existing account, please contact us at 800-247-5626 for removal paperwork.
• A minimum $5 opening deposit is required to open an account. If applying by mail, please include a check.
Opening a Premium Online Savings Account and Membership is easy at PenFed.org or by returning this form to PenFed
Box 247009, Omaha, NE 68124.
PREMIUM ONLINE SAVINGS ACCOUNT
& PENFED MEMBERSHIP APPLICATION/SIGNATURE CARD
SECTION 1: MEMBER INFORMATION
Member Name
(First, MI, Last)
: 
_________________________________________________________________________________________________________________________________________________________________________________________________________________________________
Date of Birth
(MM/DD/YYYY)
: 
____________________________
______
______
________________________________
_
_
____
 Full SSN/ITIN: 
______
____
______________________________________________________
_
__
 
c
 Check if ITIN
Mailing Address: 
_________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
Physical Address
(if dierent than mailing)
: 
___________________________________________________________________________________________________________________________________________________________________________________________________________
c
I do not have a Physical Address
(If you do not have a physical address, provide a description of your physical location on the Physical Address line above)
Day Phone: 
______________________________________________________________
 Evening Phone: 
______________________________________________________________
 Cell Phone: 
___________________________________________________
______
______
Email Address: 
________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
__
__________
c
To avoid paying a fee for mailed statements, please sign me up for FREE e-statement notifications.
(You will receive an email confirmation with instructions to confirm your e-statement option)
(If joint owner is not a U.S. resident, please complete Form 39)
1. Joint Owner’s Name
(First, MI, Last)
: 
___________________________________________________________________________________________________________________________________________________________________________________________
_______
__
Date of Birth
(MM/DD/YYYY)
: 
_______________________________________________
_______
____________
 Full SSN/ITIN: 
_______________________________________________________________
_
__
 
c
 Check if ITIN
Physical Address: 
________________________________________________________________________________________________________________________________________________________________________________________________________
_______________
_______________
c
 
I do not have a Physical Address
(If you do not have a physical address, provide a description of your physical location on the line above)
c
Individual
Upon your death, the account passes as part of your estate under your will, trust, or by intestacy. If selected, do not complete the joint ownership section.
Joint Account with Survivorship
Upon the death of a party having ownership in the account, the deceased party’s ownership passes to the surviving party(ies) of the account.
Joint Account without Survivorship
Upon the death of a party having ownership in the account, the deceased party’s ownership is considered part of the decedent’s estate under the decedent’s
will, trust, or by intestacy.
2. Joint Owner’s Name
(First, MI, Last)
: 
___________________________________________________________________________________________________________________________________________________________________________________________
_______
__
Date of Birth
(MM/DD/YYYY)
: 
_______________________________________________
_______
____________
 Full SSN/ITIN: 
_______________________________________________________________
_
__
 
c
 Check if ITIN
Physical Address: 
________________________________________________________________________________________________________________________________________________________________________________________________________
_______________
_______________
c
 
I do not have a Physical Address
(If you do not have a physical address, provide a description of your physical location on the line above)
c
Beneficiary Designation:
Upon death of all owners, this account shall be paid to the following:
1. Beneficiary’s Name
(First, MI, Last)
: 
____________________________________________________________________________________________________________________
 Full SSN:
_______________________
_____
____________________________
_
_
Physical Address: 
________________________________________________________________________________________________________________________________________________________________________________________________________
 %:
_____________________
2. Beneficiary’s Name
(First, MI, Last)
: 
____________________________________________________________________________________________________________________
 Full SSN:
_______________________
_____
____________________________
_
_
Physical Address: 
________________________________________________________________________________________________________________________________________________________________________________________________________
 %:
_____________________
3. Beneficiary’s Name
(First, MI, Last)
: 
____________________________________________________________________________________________________________________
 Full SSN:
_______________________
_____
____________________________
_
_
Physical Address: 
________________________________________________________________________________________________________________________________________________________________________________________________________
 %:
_____________________
SECTION 2: OWNERSHIP DESIGNATION
(if no selection is made, your account will be individual)
Form 220 (09/21) © Pentagon Federal Credit Union, 2021 Page 2 of 3
SECTION 3: MEMBER ELIGIBILITY
Currently employed, honorably discharged from or retired from:
c
  Air Force  
c
  Army  
c
  Coast Guard  
c
  Navy  
c
  Marines  
c
  DOD  
c
  DHS  
c
  NOAA  
c
  USPHS 
c
  Reserve or National Guard 
c
  Other: 
________________________________________________________________
 Grade/Rank: 
__________________________________________________
____
_____
Member of:
c
  ASMC  
c
  CGAuxA  
c
  MOAA  
c
  NAUS  
c
  VFW  
c
  ROA  
c
  Navy League  
c
  USAWOA 
c
  Other:
____________________________________________________________________________________________________________________________________________________________________________________________________________________
______________
_
__
_
 
c
 None of the above, but I would like to join PenFed.
SECTION 4: PURPOSE FOR MEMBERSHIP AND OCCUPATION INFORMATION
Which of our products are you interested in obtaining? (Note: Savings/checking/certificates may not be used for business purposes)
c
Mortgage  
c
  Credit Card  
c
  Auto Loan  
c
  Other Loan  
c
  Savings/Checking/Certificate
What is your occupation?
 
____________________________________________________________________________________________________________________________________________________________________________________________________
________
____________
___
__
Employer/Business Name:
___________________________________________________________________________________________________________________________________________________________________________________________
__________
_____________
___
________
SECTION 5: INTERNATIONAL ELECTRONIC FUNDS TRANSFER ACTIVITY
Do you intend to transfer funds electronically from any PenFed account to international locations?
c
Yes
  
c
 
No
  
c
 
Not Sure
  Primary Country:
_________________________________________________________
 Secondary Country:
_________________________________________________________
Sections 3 - 5 are required to ESTABLISH MEMBERSHIP. They are not required to update an account or open a secondary account.
I/we have read the attached Membership and Joint Account Agreement and, if accepted, I/we agree to comply with these terms and any amendments thereto,
and to subscribe to at least one share. I/we authorize PenFed to obtain a credit report to determine my/our eligibility for this account or other financial services
I/we may request. Under penalties of perjury, I/we certify: 1) the number shown on this form is my/our correct taxpayer identification number; and 2) I/we am/
are not subject to backup withholding because (a) I/we am/are exempt from backup withholding, or (b) I/we have not been notified by the Internal Revenue
Service (IRS) that I/we am/are subject to backup withholding as a result of a failure to report all interest or dividends, or (c) the IRS has notified me/us I/we
am/are no longer subject to backup withholding (cross out this section if you are subject to withholding); and 3) I/we am/are a U.S. person (including a U.S.
resident alien). The Internal Revenue Service does not require your consent to any provision of this document other than the certifications required to avoid
backup withholding.
By signing below, I/We acknowledge that I/we have read the attached account agreements and agree to comply with all its terms and conditions.
SECTION 6: AGREEMENT
Member Signature
x
Date
Joint Owner Signature
x
Date
Joint Owner Signature
x
Date
AUTHORIZATION FOR THE SOCIAL SECURITY ADMINISTRATION TO DISCLOSE YOUR SOCIAL SECURITY NUMBER VERIFICATION
I authorize the Social Security Administration (SSA) to verify and disclose to PenFed through SentiLink Corp. their service provider, for the purpose
of this transaction whether the name, Social Security Number (SSN) and date of birth I have submitted matches the information in SSA records. My
consent is for a one-time validation within the next 30 days.
By signing below, I/we acknowledge that I/we have read the SSA disclosure and authorize the Social Security Administration (SSA) to provide my
Social Security Number Verification.
Form 220 (09/21) © Pentagon Federal Credit Union, 2021 Page 3 of 3
MEMBERSHIP AGREEMENT
Thewords“I”“me”“my”“myself”meaneachpersonsigningthe
membershipapplicationsignaturecardincludinganyonewhohas
accesstotheaccount(s)
 IunderstandthatthisaccountshallbegovernedbytheCode
ofVirginiafederallawsNationalCreditUnionAdministration
(NCUA)RulesandRegulationsandthebylawsandpoliciesand
proceduresoftheCreditUnionandanyamendmentsthereto
This account shall be subject to other terms and conditions
whicharesubjecttochangeuponnoticetome
 I agree that PenFed has the right pursuant to its statutory
lienand further Igivemyexpress consentto enable PenFed
tochargeagainstanybalanceinanyofmyPenFedaccounts
includingaccountsonwhichIamajointownertoincludeany
otherwisestatutorilyprotected fundsthatmaynototherwise
be available by legal process to liquidate any PenFed
indebtednessowedbymeoranypersonwhoislistedasajoint
owneronmyaccountswithPenFedincludingadeceasedjoint
ownerThisprovisiondoesnotincludemyIRAaccountorany
otheraccountforwhichthisprovisionisnotpermittedunder
InternalRevenueCodePenFedmaytakesuchactionwithout
further notice to me or any joint owner In regard to those
fundsthathaveastatutoryprotectionIunderstandthatImay
withdrawmyexpressconsentforPenFedtoapplysuchfunds
topayanysuchindebtednessbynotifyingPenFedinwriting
IfmyconsentiswithdrawnPenFedmayinitssolediscretion
terminateanyandallservicesthatIhavewiththecreditunion
 IexpresslyauthorizePenFedtoprocureuponitsrequestfrom
anypersonpartnershipcreditreportingagencyassociation
firm or corporation a credit report and for such person to
furnishPenFedwithsaidcreditreportconcerninganyfinancial
service I may request or obtain from PenFed as well as any
subsequentre-evaluationofanysuchfinancialservice
 IfIhavecausedPenFedtoincuranylossduetomyactivities
orifanyaccountatPenFedismaintainedbymeinamanner
that PenFed in its sole discretion deems contrary to sound
financial practice I agree that PenFed may terminate all
accountsorserviceswhichImayreceivefromPenFedwiththe
exceptionofmyRegularShareaccount
 I understand that if all my shares in PenFed are withdrawn
my membership in PenFed may be terminated Funds in my
accountswillbesubjecttocollectionthroughnormalbanking
channelsandPenFed’sholdpolicy
 Iagreethatmyshareaccountsarenottransferableexcepton
therecordsofPenFed
 Iagreethat paymentofmoneyin theaccountonthewritten
instructions of any authorized person excuses PenFed of
any further legal obligation regarding the proceeds of the
transaction I agree to indemnify and hold PenFed harmless
from any suits or liability directly or indirectly resulting
from the handling of the account consistent with the written
instructions of any authorized person PenFed may refuse to
honor my instruction if it is unclear or the signature appears
nottobeauthentic
 Any financial service provided by PenFed may be used for
any transaction permitted by law I agree that illegal use of
anyfinancialservicewillbedeemedanactionofdefaultand
or breach of contract and such service andor other related
services may be terminated in PenFed’s discretion I further
agreeshouldillegaluseoccurtowaiveanyrighttosuePenFed
forsuchillegaluseoranyactivitydirectlyorindirectlyrelated
to it and additionally I agree to indemnify and hold PenFed
harmlessfromanysuitsorotherlegalactionorliabilitydirectly
orindirectlyresultingfromsuchillegaluse
______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
IMPORTANT: PLEASE READ AND RETAIN FOR YOUR RECORDS
JOINT SHARE ACCOUNT AGREEMENT
If any of my accounts either now or in the future are established
as a joint account PenFed is authorized to recognize any one of
the joint owner signatures for the payment of funds or for any
transaction for this account The joint owners of this account agree
with each other and with PenFed that all funds deposited into the
account shall be owned jointly by all joint owners The funds on
deposit will be subject to the withdrawal or receipt of any joint
owner In the event of death of an owner and according to the
type of joint share account selected withdrawal or payment may
also be made to the survivor(s) or the estate(s) of the deceased
owner(s)Each joint owner will discharge PenFed from any liability
for the payment or withdrawal
A joint owner who is a PenFed member may pledge all or part
of the shares in this account as collateral security for a loan or
loans and PenFed is authorized to charge at any time against this
account any indebtedness owing to it by any of the joint owners
Please note: Joint ownership does not constitute membership.
This account shall be governed by the Code of Virginia Federal
Laws Rules and Regulations and the Bylaws of PenFed and any
amendments thereto
TRANSACTION LIMITATIONS
Federal Regulation D limits the following to no more than a total
of  per monthly dividend cycle transfers or withdrawals made to
another PenFed account (other than for the purpose of repaying
a PenFed loan and associated expenses) if made by preauthorized
or automatic transferby telephone or fax or via PenFed Online
(PFOL) or the mobile application transfers or withdrawals to a
third party if made by preauthorized or automatic transfers by
telephone or fax or via PFOL or transfers to a third party if made
by check draft or similar order made by me and payable to a third
partyIf I exceed these limitations my account will be subject to an
excessive transaction fee and may be closed
PenFed is federally insured by the National Credit Union
Administration (NCUA) The information in this form is current as
of September 1 and is subject to change To determine if
changes have occurred since printing call -- Our
address in accordance with NY Law is  Jones Branch Drive
Tysons VA 
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PREMIUM ONLINE SAVINGS ACCOUNT

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Completed 14 December 2021

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