Application for Club Account (Holiday or Vacation Club)
Please complete the form below:
*Indicates a required field.
Member Account Number
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SSN#
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First Name
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Last Name
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Address
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Address Line 2
City
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State
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- - Choose One - -
AL
AK
AZ
AR
CA
CO
CT
DC
DE
FL
GA
HI
ID
IL
IN
IA
KS
KY
LA
ME
MD
MA
MI
MN
MS
MO
MT
NE
NV
NH
NJ
NM
NY
NC
ND
OH
OK
OR
PA
RI
SC
SD
TN
TX
UT
VT
VA
WA
WV
WI
WY
Home Phone (no characters)
*
Business Phone (no characters)
Email Address (Please provide if you would like email notification of form submission)
Type Of Account Applying For:
(You may select both)
*
VACATION Club Account
HOLIDAY Club Account
VACATION DEDUCTION
:
Amount (minimum $5.00) to be deducted from my salary or sick pay benefits every payday for deposit to my credit union VACATION Club Account.
*Please enter 0.00 or other amount
*
HOLIDAY DEDUCTION
:
Amount (minimum $5.00) to be deducted from my salary or sick pay benefits every payday for deposit to my credit union HOLIDAY Club Account.
*Please enter 0.00 or other amount
GUIDELINES FOR CLUB ACCOUNTS
:
About Both Types of Club Accounts
1. You must be a member of the Credit Union to qualify for Club Accounts.
2. If you already have a Club Account from the previous year, it will continue unless you notify the Credit Union office in writing to change the amount of your payroll deduction or to discontinue the Account.
3. The dividend rate on Club Accounts will be anticipated monthly and declared quarterly. The rate is calculated from the day of deposit, compounded quarterly, credited quarterly and at the end of the Club year.
About Holiday Club Accounts
1. Holiday Club Accounts may be opened at any time.
2. Withdrawals from Holiday Club Accounts are not permitted.
3. Holiday club Accounts closed prior to the end of the Club year, which is typically during October, will be assessed a ten dollar ($10.00) penalty.
4. Completed Holiday Club Accounts will be transferred to your Share Savings Account during the month of October. Funds must be accessed through an ATM, our ABC voice response system or by requesting a withdrawal through the secure mailbox on Virtual Branch Online Banking.
About Vacation Club Accounts
1. Vacation Club Accounts may be opened at any time.
2. Two withdrawals within a twelve (12) month period are permitted for Vacation Club Accounts. Excess withdrawals will be charged at ten dollars ($10.00) each.
*
Yes, I understand that Club deductions will be included with regular Share entry on my payroll register. I have read and will comply with Club rules, as outlined
in the Guidelines above.
ELECTRONIC FORM SUBMISSION AGREEMENT
:
By submitting this form I am verifying the following:
1. The above information entered has indeed been entered by myself, the account owner or joint owner, and that submission of this form gives full authority to conduct the transaction requested above.
2. I understand that I do have the option or right to submit this form in the paper form, which is available either through our website at www.fafcuny.org and/or upon request by contacting the credit union.
3. I understand that I exercise the right to withdraw consent to have records provided electronically, including any conditions, consequences, or fees associated with doing so. To withdraw consent I must submit written documentation with my request and verify receipt of its retrieval.
4. By entering my first and last name next to the Electronic Signature field, this stands as the equivalent of a handwritten signature. Therefore, the same laws and regulations regarding forgery apply.
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Yes, I agree to the terms and conditions of submitting this form Electronically as outlined in the guidelines above.
Electronic Signature (Print First & Last Name)
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Date
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Office Location (City & State)
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Company Name
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