Oswego Teachers EFCU Member Application

Will this be a Single or Joint Application?

Single Application

Joint Application

First Name*

Last Name*

Email*

Phone (Best contact phone #)*

No dashes, spaces, or parentheses

Social Security No.*

No dashes, spaces, or parentheses

Driver's License No.*

No dashes, spaces, or parentheses

Driver's License State *

Date of Birth *

Address *

Address 2

City *

State *

Zip Code *

Employment information

Current Employer *

Position *

Employee Start Date *

Beneficiary

Beneficiary cannot be a signer on the account.

Full Name*

Present Address*

Address 2

City*

State*

Zip Code*

Social Security Number

Disclosure and Agreement to Terms

By completing and submitting this document, I certify, under penalties of perjury

that the Social Security Number (SSN)/Taxpayer Identification Number (TIN) shown is my/the correct number

that I am NOT, unless designated below, 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 dividends or interest, or because the IRS has notified me that I am no longer subject to backup withholding

that I am a U.S. person (including a U.S. resident alien)

By clicking the submit button: I hereby make application for membership in and agree to conform to the OSWEGO TEACHERS EMPLOYEES FEDERAL CREDIT UNION Membership and Account Agreement . In considering this application, Oswego Teachers’ Federal Credit Union may request and use reports from outside reporting agencies. If you request it, we will tell you whether or not we asked for such a report, and, if we have, the name and address of the agencies. I acknowledge notice of this disclosure and I also agree to the terms and conditions of any account that I have in the credit union now or in the future and agree that the credit union may change those terms and conditions from time to time.

Do you agree with the above terms and conditions? *

Yes, I agree to the terms

No, I do not agree to the terms

Signature (type your full name) *

Date *

Upload the most recent copy of your identification

Joint Applicant - Personal information

First Name*

Last Name*

Email*

Phone (Best contact phone #)*

No dashes, spaces, or parentheses

Social Security No.*

No dashes, spaces, or parentheses

Driver's License No.*

No dashes, spaces, or parentheses

Driver's License State *

Date of Birth *

Address *

Address 2

City *

State *

Zip Code *

Employment information

Current Employer *

Position *

Annual Income *

Employee Start Date *

Co-Applicant

Do you agree with the above terms and conditions? *

Yes, I agree to the terms

No, I do not agree to the terms

Signature (type your full name) *

Date *

Upload the most recent copy of your identification