Identification Form For You And Your Attorney-In-Fact Page 3

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Identification Form for You and Your Attorney-in-Fact
IMPORTANT INFORMATION. Federal law requires us to obtain, verify, and record the
name, address, date of birth, and other information of you and your attorney-in-fact that
will allow us to identify you or your attorney-in-fact when opening an account in certain
other circumstances.
Your (Grantor) Information
Your Name:
First
MI
Last
USAA Number
Social Security Number Date of Birth (mm/dd/yy)
Your Attorney-in-Fact Information
Name:
First
MI
Last
USAA Number (if applicable)
Social Security Number Date of Birth (mm/dd/yy)
Relationship to member (e.g., parent, spouse, child or friend)
Telephone Number
Physical Address (P.O. Box cannot be accepted)
City
State
Zip Code
Mailing Address (if different)
City
State
Zip Code
Employer's Name
Occupation/Type of Business
Employer's Address
City
State
Zip Code
Is your attorney-in-fact a senior political figure or family member or associate of a senior foreign
political figure?
o Yes
o No
Is your attorney-in-fact a U.S. Citizen?
oYes
o No
If no, please specify country of citizenship
AND provide one or
more of the following valid numbers:
U.S. Alien Identification Card number
Passport Number Issued by Country of Citizenship
Resident Status:
o Resident Alien
o Non-resident Alien
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