Checking Account Application

* Indicates Required Field

Application type *
Individual Joint
Account type *
Opportunity Plus Money Maker MaxReturns

Member Information

Name *
Member Number *
Social Security Number/Tax ID Number (Last Four)*

Joint Applicant #1

Name *
Member Number *
Social Security Number/Tax ID Number *
Photo ID *
Accepted formats: .pages, .doc, .docx, or .pdf

Joint Applicant #2

Name
Member Number
Social Security Number/Tax ID Number
Photo ID
Accepted formats: .pages, .doc, .docx, or .pdf

Payable on Death Designation

The undersigned and Illiana Financial Credit Union hereby agree that the subject account and any balance therein which exists from time to time shall be held as a Payable on Death Account and that, upon the death of the undersigned, the account shall be payable to and owned by the following designated person(s).

Beneficiary #1

Name
Social Security Number/Tax ID Number
Address
City
State
Zip Code

Beneficiary #2

Name
Social Security Number/Tax ID Number
Address
City
State
Zip Code

A. CHECKING AGREEMENT: I/we have read and hereby accept the Checking Account Agreement noted on the reverse of this brochure.

B. CERTIFICATION: Under penalties of perjury, I certify that (1) the number shown on this form is my correct taxpayer identification number (or I am waiting for a number to be issued to me), and (2) I am not subject to backup withholding either 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 as a result of a failure to report all interest, or (c) the IRS has notified me that I am no longer subject to backup withholding.

Certification Instructions: You must let us know in the additional details area (2) if you have been notified by the IRS that you are currently subject to backup withholding because you have failed to report all interest on your tax return. The Internal Revenue Service does not require your consent to any provision of this document other than the certifications required to avoid backup withholding.

The undersigned and Illiana Financial Credit Union further agree that:

The undersigned during his or her lifetime may change any of the designated persons to own the account at his or her death, by a written instrument accepted by the Illiana Financial Credit Union, without the knowledge or consent of the designated person(s);
The undersigned may make additional deposits to and withdraw all or any part of the account at anytime, without the knowledge or consent of the designated person(s) to own the account at his or her death, subject to the bylaws and regulations of the Illiana Financial Credit Union, and that all withdrawals shall constitute a revocation of the agreement as the amount withdrawn;
Upon the death of the undersigned, the person(s) designated to be the owner of the account and then living, shall own the account in equal shares as tenants in common;
Upon the death of the undersigned, if no person designated to be the owner is then living, the proceeds shall vest in the estate of the undersigned; and
Any payments made by Illiana Financial Credit Union in accordance with this designation prior to the receipt of an adverse claim or a restraining order shall be a complete discharge of the Illiana Financial Credit Union's obligations and shall constitute a release of the Illiana Financial Credit Union from all claims of any person as to the amount so paid.
If joint owners decease at the same time or if one joint owner predeceases the other upon the death of the remaining joing owner(s), funds will be dispersed as designated in the Payable on Death Clause.

Electronic Signature Agreement
I agree to use an electronic signature on this electronic document. (Read More) *
Name (Signature) *
Joint Applicant Name (Signature) *
Joint Applicant Name (Signature)