Share/Savings Account Application

Please print and complete this application and mail it to Atlantic Federal Credit Union, 37 Market St., Kenilworth, N.J. 07033. Enclose a $25 check or money order as your initial deposit and copies of two Ids. One should be a government issued photo ID (driver's license, passport, county ID card). Also enclose a copy of a recent paystub to validate employment eligibility. If you are joining as a family member, submit copies of a photo ID and Social Security card.

Share/Savings Account

Name_____________________________

Soc Sec No._________________________

Street________________________

City_________________ State____ Zip________

Home Phone Number______________________

Date of Birth_____________________

Driver's Lic. #__________________________ State Issued_____

E-mail address_____________________________

Mother's Maiden Name_______________

Place of Employment______________________

Business Phone__________________

Employer Address_____________________

City______________ State____ Zip_____

If joining as family, indicate your relationship to member_____________________

Ownership Type (check one):

___ Individual  ___ Joint Member  

___ Custodian for minor  ___ Revocable Trust

___ Payable on Death (List Name & Address of Beneficiary Below)

__________________________________________________________


Joint Member Name________________________

Soc Sec No.__________________

Street_______________________________

City____________ State_____ Zip________

Home Phone Number________________________

Date of Birth____________________

Member Signature & Date_______________________________________________

Joint Member Signature & Date__________________________________________

Sign me up for E-Statements! Send my statements electronically to my email address rather than mailing me a paper statement.
Yes____ No____

Send me the Credit Union's FREE periodic Electronic Newsletter that contains fast breaking credit union news and advance notice of special credit union promotions.
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