Member Information App Type App Type Folder

Primary Information

Everest FCU Member Application

Will this be a Single or Joint Application?*

Single Application

Joint Application

Which account type would you like to open?*

Regular Share [this account is required to become an EFCU member]

Special Share Saving

Share Draft / Checking

CD [6 months; 12 month; 18 month; 24 month; 36 month; 48 month; 60 month]

Holiday / Vacation Club

Retirement Account [ROTH IRA, Traditional IRA]

Referred By*

Primary Account Holder

First Name*

Middle Initial

Last Name*

Date of Birth *

Social Security No.*

No dashes, spaces, or parentheses

Driver's License / Photo ID No.*

No dashes, spaces, or parentheses

Driver's License State *

Address *

Address 2

City *

State *

Zip Code *

Email*

Phone (Best contact phone #)*

No dashes, spaces, or parentheses

Employment Information

Current Employer

Position

Employee Start Date

ACH Information

Account Holder Name

Financial Institution Name

City

State

Zip Code

Routing Number

Account Number

Type of Account

Checking Account

Savings Account

Effective Date of First Debit

Total Debit Amount

Beneficiary

Full Name

Present Address

Address 2

City

State

Zip Code

Social Security Number

File Upload Center

Primary Account Holder

Upload a copy of your Driver's License

Upload a copy of your Proof of Address

Individual Membership Form

Business Membership Form

Disclosure and Agreement to Terms

You will need the following information in order to complete the application:

A valid form of identification; Government issued ID/Drivers License/State ID or Passport with current address
Your complete physical and mailing address; Previous home address (if you have lived at your current home address less than two years)
Social Security Number/Individual Taxpayer Identification Number
Date of Birth

(You must be 18 years of age or older.)

Review the disclosures below to set up your account.

USA Patriot Act

Federal law requires that we obtain, verify and record information that identifies each person who opens an account, including joint owners. Within this application, 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. Approval of your application may be delayed pending further verification of your identity.

Consumer Reports

I authorize Everest Federal to obtain consumer reports about me during my membership to consider me for offers of or related to Everest Federal products and services. I also authorize Everest Federal to obtain consumer reports to evaluate this membership application and review any Everest Federal accounts I open. I understand these reports may be used in decisions to deny account applications, close accounts and/or restrict accounts or services.

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 an 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 and may consult consumer reports or credit bureaus to verify your identity.Please review the account disclosures and agreements below. These documents contain many of the terms and conditions that will apply to your account(s). You will need to open and review each document before proceeding. We recommend that you print or save a copy of each of these documents for future reference. By selecting "Yes, I agree to the terms" you authorize us to verify the information you submitted and to obtain credit reports concerning you. Upon your request, we will tell you if a credit report was obtained and give you the name and address of the credit reporting agency that provided the report. You warrant to us that the information you are submitting is true and correct. By submitting this application, you agree to allow us to receive the information contained in your application, as well as the status of your application.

Do you agree with the above terms and conditions? *

Yes, I agree to the terms

No, I do not agree to the terms

Sign Below*

Joint Information

Joint Applicant - Personal information

First Name*

Middle Initial

Last Name*

Date of Birth *

Social Security No.*

No dashes, spaces, or parentheses

Driver's License / Photo ID No.*

No dashes, spaces, or parentheses

Driver's License State *

Address *

Address 2

City *

State *

Zip Code *

Email*

Phone (Best contact phone #)*

No dashes, spaces, or parentheses

Employment Information

Current Employer

Position

Employee Start Date

File Upload Center

Joint Account Holder

Upload a copy of your Driver's License

Upload a copy of your Proof of Address

Signature Card

Sign Below*

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