Membership Account Application (Page 2 of 2) in pdf

Designation On Payable-On-Death Beneficiary

All account types under this member number

Specific account type(s)

(NOT for use with HSA, IRA or Share Certificates. Use separate specially designated forms)

Cannot be the same person as joint owner.

Beneficiary Information

Name

Social Security #

Date of Birth

% of Distribution

Street Address (P.O. Box not permitted)

City

State

Zip

Name

Social Security #

Date of Birth

% of Distribution

Street Address (P.O. Box not permitted)

City

State

Zip

Name

Social Security #

Date of Birth

% of Distribution

Street Address (P.O. Box not permitted)

City

State

Zip

TOTAL DISTRIBUTION

Notice: All beneficiaries are subject to an OFAC review before being added or prior to disbursal of funds. A Payable-On-

Death Beneficiary on a joint account will not have access to account funds unless all owners are deceased. Once signed

(Total should add up to 100%)

and dated, this formwill supersede any previously dated formon file.

Visa Debit Card

Acknowledgement: Further, by signing this form, I (we) acknowledge receipt of the Electronic Funds Transfer Act (Regulation E)

Check Appropriate Box:

Primary

Joint

E-Consent Communications Agreement

CONSENT FOR ELECTRONIC COMMUNICATION

By signing you affirmatively agree and authorize the Credit Union to conduct business with you electronically. This disclosure documents your consent to conduct transactions electronically and to electronically receive

disclosures and notices relative to the accounts you are applying to open with us online and other products and services we may offer. The disclosure also describes your rights relative to conducting transactions

electronically and to electronically receiving disclosures and notices, as well as the consequences of withdrawing your consent. We recommend you print and retain a copy of this disclosure and all the disclosures and

agreements related to this transaction.

The information may include, but is not limited to:

•

Account Alerts

•

Annual Privacy Notice with opt-out option

•

Billing Rights

•

Disclosures

•

E-Documents (E-Statements, E-Notices, and E-Receipts)

•

Electronic Funds Transfer Disclosure

•

Funds Availability Policy

•

Notice of change in terms for your deposit account

•

Notice of change in schedule of fees

•

Terms and Conditions of your deposit account

•

Truth-In-Savings

Please see Membership Agreement Booklet for full E-Consent Communications Agreement

Account Agreement

I am applying for membership in Coca-Cola Federal Credit Union. Each applicant for membership certifies that they are eligible for membership in Coca-Cola Federal Credit Union’s field of membership. All of the

information on the application is accurate and true and the account is subject to closure if false information is provided.

I agree to abide by the bylaws as well as all applicable terms and conditions set forth in the Account Agreement and the Rate and Fee Schedule, all of which receipt is here by acknowledged and which are incorporated

by this reference.

I authorize you to verify and gather whatever credit, checking account, and employment information you consider appropriate from time to time. I understand this will assist you, for example, in determining my initial

and ongoing eligibility for my Accounts and/or in connection with making future credit opportunities available to me.

This application serves as the Master Membership Account Application or Supplemental Application, and controls all subaccounts opened under this member number, except Individual Retirement Accounts (IRAs) and

Trust Accounts, and is a continuing authorization to open any other account for me on my verbal request and deposit of funds.

NOTE: Included is my initial U.S. Dollar deposit into my Share/Savings Account in the amount of $

($10.00 minimum opening deposit requirement must be maintained at all times in your Share/Savings Account).

You may return this form using the following methods:

Mail: Coca-Cola Credit Union, PO Box 1734, Atlanta, GA 30301-1734

Fax: 404-598-2586

Email:

New Member’s Signature

Date

Joint Owner’s Signature

Date

Membership Account Application • Page 2 of 2