WVUEFCU New Member Application



Share / Savings required for Membership ($6.00 minimum deposit)

Share/Savings
Share Certificate ($1,000 minimum deposit)
Share Draft/Checking
Holiday Club
Vacation Club
9-month Club
Individual
Joint
Payroll deduction authorization
Mail check to credit union

Primary Account Holder




Landline
Mobile
Landline
Mobile


Employment


TIN Certification and backup withholding information


By completing and submitting this document, I certify, under penalties of perjury

  1. that the Social Security Number (SSN)/Taxpayer Identification Number (TIN) shown is my/the correct number

  2. that I am NOT, unless designated below, subject to backup withholding either because I have not been notified that I am subject to backup withholding as a result of a failure to report all dividends or interest, or because the IRS has notified me that I am no longer subject to backup withholding

  3. that I am a U.S. person (including a U.S. resident alien)