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 identifies each person who opens a new account.

WHAT THIS MEANS FOR YOU:

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.  We may also ask to see your driver's license or other identifying documents.



Artesia Credit Union Membership Application

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Instructions

Please provide all the requested information. When you have completed the form, press the Submit button to send your application. If necessary, we will contact you for additional information.

The items marked with (*) are required fields.

General Information

Will there be a co-applicant on this application?

Membership Eligibility

*I am eligible for membership through:

Primary Applicant

*
*
*
*
*
TIN/Backup Withholding/US Person

Home Address (not P.O. Box)

*
*
*
*

Time at Current Residence

Residence Type

Mailing Address (if different)

Employment History

Employer's Address

CoApplicant

Home Address (not P.O. Box)

Time at Current Residence

Residence Type

Mailing Address (if different)

Employment History

Employer's Address

References

Nearest relative Not Living With You

Additional Information

How would you prefer to be contacted?

IMPORTANT: Please only select "Submit Application" once. It may take a few moments for the confirmation to appear.