Member Application and Agreement

We look forward to helping you become a member at EMCCU! To complete this application quickly and efficiently, we suggest you have the following documents available:

A copy of a valid or non-expired state-issued identification card (or driver’s license) in a JPEG or PDF format
A copy of a recent utility bill, paystub or W-2 in case your current address doesn't match your driver's license or state-issued ID

Please contact us if you have any questions!

(*) indicates a required field

Account Ownership

Designate the ownership of the accounts and responsibility for the services requested.

Account Ownership*

Invalid Input

Are you 18 or older?*

Invalid Input

If you are under the age of 18, you can still apply, but a parent or guardian over the age of 18 must also apply as a joint applicant.

How did you hear about us?*

Invalid Input

Please explain how you found us!*

Invalid Input

Disclosures*

Yes, I've read and agree to the following:

You must agree to the disclosures to proceed!

For your convenience, we will automatically send you PDFs of our disclosures after you’ve successfully submitted your application.

First Name*

Invalid Input

Middle Name

Invalid Input

Last Name*

Invalid Input

Physical Address (cannot be a P.O. Box)*

Invalid Input

City*

Invalid Input

State*

Invalid Input

Zip Code*

Invalid Input

Check here if your mailing address is different than above (P.O. Box is acceptable)

You must agree to the disclosures to proceed!

Mailing Address*

Invalid Input

City*

Invalid Input

State*

Invalid Input

Zip Code*

Invalid Input

Primary Phone Number*

Please enter your primary phone number

Secondary Phone Number

Invalid Input

E-Mail Address*

Invalid Input

Social Security Number/TIN*

Invalid Input

Are you a U.S. citizen?*

Invalid Input

Please provide your valid driver's license, state ID or Passport information.

Please provide two forms of valid ID. This could be your foreign passport or green card or valid government-issued identification.

ID Type*

Invalid Input

ID Type*

Invalid Input

State Issued ID Number*

Invalid Input

State of Issue*

Invalid Input

Expiration Date*

Invalid Input

Passport Number*

Invalid Input

Permanent Resident Card ID#*

Invalid Input

Passport Country*

Invalid Input

Permanent Resident Card Expiration Date*

Invalid Input

ID Type*

Invalid Input

State Issued ID Number*

Invalid Input

State of Issue*

Invalid Input

Expiration Date*

Invalid Input

Passport Number*

Invalid Input

Passport Country*

Invalid Input

Permanent Resident Card ID#*

Invalid Input

Permanent Resident Card Expiration Date*

Invalid Input

Please make sure you submit a photo (JPG) or scan (PDF) of your valid form of ID. Make sure your information is clearly visible. Please be sure the PDF does not exceed 5MB.

The PDF/photo must include following information: Photo, Full Legal Name, ID Number, Expiration Date, County of Origin (if applicable).

Please provide a photo of your ID*

Invalid Input

Please provide a photo of your ID*

Invalid Input

Birthdate (MM-DD-YYYY)*

Invalid Input

Mother's Maiden Name*

Invalid Input

Employer Name*

Invalid Input

Occupation*

Invalid Input

Business Phone Number*

Invalid Input

Retired? Please input your previous occupation

Invalid Input

How are you eligible for membership? Check your eligibility.*

Invalid Input

Please provide Member Name*

Invalid Input

Please provide Member Account Number (optional)

Invalid Input

Please provide your relationship to the Member*

Invalid Input

Please select eligible city*

Invalid Input

Please note you may be asked to provide proof of employment, school registration or church affiliation to complete the application process.

Joint Owner Information

First Name*

Invalid Input

Middle Name

Invalid Input

Last Name*

Invalid Input

Physical Address*

Invalid Input

City*

Invalid Input

State*

Invalid Input

Zip/Postal Code*

Invalid Input

Check here if your mailing address is different than above (P.O. Box is acceptable)

You must agree to the disclosures to proceed!

Mailing Address*

Invalid Input

City*

Invalid Input

State*

Invalid Input

Zip/Postal Code*

Invalid Input

Primary Phone Number*

Invalid Input

Secondary Phone Number

Invalid Input

E-Mail Address*

Invalid Input

Social Security Number*

Invalid Input

Are you a U.S. citizen?*

Invalid Input

Please provide your valid driver's license, state ID or Passport information.

Please provide two forms of valid ID. This could be your foreign passport or green card or valid government-issued identification.

ID Type*

Invalid Input

ID Type*

Invalid Input

State Issued ID Number*

Invalid Input

State of Issue*

Invalid Input

Expiration Date*

Invalid Input

Passport Number*

Invalid Input

Permanent Resident Card ID#*

Invalid Input

Passport Country*

Invalid Input

Permanent Resident Card Expiration Date*

Invalid Input

ID Type*

Invalid Input

State Issued ID Number*

Invalid Input

State of Issue*

Invalid Input

Expiration Date*

Invalid Input

Passport Number*

Invalid Input

Passport Country*

Invalid Input

Permanent Resident Card ID#*

Invalid Input

Permanent Resident Card Expiration Date*

Invalid Input

Please make sure you submit a photo (JPG) or scan (PDF) of your valid form of ID. Make sure your information is clearly visible. Please be sure the PDF does not exceed 5MB.

The PDF/photo must include following information: Photo, Full Legal Name, ID Number, Expiration Date, County of Origin (if applicable).

Please provide a photo of your ID*

Invalid Input

Please provide a photo of your ID*

Invalid Input

Birthdate (MM-DD-YYYY)*

Invalid Input

Mother's Maiden Name*

Invalid Input

Employer Name*

Invalid Input

Occupation*

Invalid Input

Business Phone Number*

Invalid Input

Retired? Please input your previous occupation

Invalid Input

Account Designations

Payable-On-Death Account Beneficiary Designation

In the event of my death, or if there is more than one owner of this account, in the event of death of all the owners, the owner(s) hereby designate as my/our beneficiary(ies) to receive all sums in my/our account established on this form.

Please note: If you elect multiple beneficiaries and you do not allocate percentages to each beneficiary, the funds will be split equally among the surviving beneficiaries.

Number of beneficiaries*

Invalid Input

First Beneficiary/POD Payee*

Invalid Input

Address*

Invalid Input

State*

Invalid Input

Phone Number

Invalid Input

Relationship*

Invalid Input

City*

Invalid Input

Zip/Postal Code*

Invalid Input

Birthdate (MM-DD-YYYY)*

Invalid Input

Percentage

Invalid Input

Name of 2nd Beneficiary*

Invalid Input

Address*

Invalid Input

State*

Invalid Input

Phone Number

Invalid Input

Relationship*

Invalid Input

City*

Invalid Input

Zip/Postal Code*

Invalid Input

Birthdate (MM-DD-YYYY)*

Invalid Input

Percentage

Invalid Input

Please note the percentages allocated to your beneficiaries must equal 100 percent in order to submit your application.

Membership Type

Please Note: There is a one-time, refundable pledge amount of $5.00 at the time of opening your account plus a $5.00 Minimum Deposit.

Account Type(s)*

Regular Share Account (Savings) ($5.00 minimum one-time initial deposit)

FREE Checking Account (no minimum deposit), also select "Checking Overdraft Protection" in next section

MasterCard Debit Card (for checking accounts only)

Invalid Input

Checking Overdraft Protection

Checking Account overdrafts can be covered in several different ways:

Please select:*

Yes, I want Checking Overdraft Protection transferred from Savings

No, I do not want Checking Overdraft Protection

Invalid Input

Courtesy Pay

Courtesy Pay is a service available on checking accounts that allows us to pay an item presented for payment against your checking account even if it causes the account to become overdrawn. The fee is $28 and this service is available to you after your account has been established for 90 days.

Please select:*

Yes, I want to opt in to Courtesy Pay

No, I do not want to opt in to Courtesy Pay

Invalid Input

Member Link Audio Response Account Access

24-hour access to my accounts by Member Link (Audio Response) will automatically be established unless declined by me. A Personal Identification Number (PIN) will be established by calling Member Link.

Please select:*

Yes, I want access to Member Link (Audio Response)

No, I do not want access to Member Link (Audio Response)

Invalid Input

Taxpayer Identification Number Certification and Backup Withholding Information

Have been notified by the IRS that you are currently subject to backup withholding because you failed to report all interest and dividends on your tax return?

Invalid Input

Are you a US Citizen?

Invalid Input

You have answered that you are NOT a US citizen. Please provide a completed IRS W-8 BEN Form.

W-8 File Upload*

Invalid Input

(1) The number shown on this form is my correct taxpayer information number (or I am waiting for a number to be issued), and

(2) I am not subject to backup withholding because (a) I am exempt from backup withholding, or (b) I have not been notified by the Internal Revenue Service (IRS) that I am subject to backup withholding, and

(3) I am a U.S. citizen or other U.S. person (including U.S. resident alien)

(4) The FATCA code(s) entered on this form (if any) indicating that I am exempt from FATCA reporting is correct.

Invalid Input

We will be unable to open an Account for You without a taxpayer identification number.

Exempt payee code (if any)

Invalid Input

Exemption from FATCA reporting code (if any)

Invalid Input

Text Message Opt-In*

You agree that El Monte Community Credit Union may from time to time make calls and/or send text messages to you at any telephone number associated with your current or future account(s), including wireless telephone numbers that could result in charges to you. The manner in which these calls or text messages are made to you may include, but is not limited to, the use of prerecorded/artificial voice messages and/or automatic telephone dialing system. You further agree that El Monte Community Credit Union may send e-mails to you at any e-mail address you provide us or use other electronic means of communication to the extent permitted by law. You understand that message and data rates may apply for texts and calls. Consent is not required as a condition of membership, loan, or any service. You may revoke your consent at any time by contacting us through reasonable means.

Invalid Input

Agreement

I hereby apply for membership in El Monte Community Credit Union (EMCCU) with this application and certify that I qualify for membership based on the eligibility stated in this application. I further understand that to continue my membership in EMCCU, I must maintain an EMCCU deposit account. I authorize you to gather whatever credit, checking account and employment information you consider appropriate from time to time. I understand that this will assist you in determining my initial and ongoing eligibility for an account. I authorize you to give informaton concerning your experience with me to others. THIS INSTITUTION IS NOT FEDERALLY INSURED, AND IF THE INSTITUTION FAILS, THE FEDERAL GOVERNMENT DOES NOT GUARANTEE THAT DEPOSITORS WILL GET BACK THEIR MONEY. MEMBER SAVINGS ARE INSURED UP TO $250,000 PER ACCOUNT BY AMERICAN SHARE INSURANCE, THE NATION'S LARGEST PRIVATE DEPOSIT INSURERS.

Acknowledgement of Receipt Disclosure

By signing the Membership Application and Agreement, I acknowledge that I have received a copy of the Credit Union's Truth-in-Savings Disclosure and Electronic Services Disclosure and Agreement and that I have received a copy of the current Rate Sheet and Fee Schedule. I agree to be bound by the terms and conditions of the Credit Union's Account Agreement(s) and any amendments thereto. I understand that any new account information will be verified. Note: The Internal Revenue Service does not require your consent to any provision of this document other than the certifications required to avoid backup withholding.

USA Patriot Act - Important Information About Procedures for Opening a New Account: To help the government fight the funding of terrorism and money laundering activities, Federal law requires all financial institutions to obtain, verify, and record information that on personal accounts identifies each person who opens an account. In addition, on Legal Entity accounts, we will require identification on beneficial owners and one individual that has significant managerial responsibility for the Legal Entity. When you open an account, we will ask for your name, address, date of birth, and other information that will allow us to identify you. For Legal Entity accounts, we are required to ask you for identifying information (name, address, date of birth, social security number and identification documents). We may also ask to see your driver's license or other identifying documents. We proudly support all efforts to protect and maintain the security of our customers and our country.

Signature*

Sign Above

Invalid Input

Date*

Invalid Input

Joint Signature*

Sign Above

Invalid Input

Date*

Invalid Input