Riverdale Credit Union

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New Member Application

Please provide all the requested information. When you have completed the form, press the Submit button to send your application.   You will hear from us in two to four working days.


Required fields are marked with an *
Savings Account Type
Individual Account  Joint Account 
Other (explain) 
 
Applicant Information Co-Applicant Information
Full Name* 
 
Full Name 
 
Address* 
 
Address 
 
City* 
City 
State/Province* 
State/Province 
ZIP/Postal Code* 
 
ZIP/Postal Code 
 
Country* 
Country 
Social Security Number* 
 
Social Security Number 
 
Mother's Maiden Name 
Home Phone* 
 
Home Phone 
 
Work Phone 
Best Time to Call                       Weekdays  Weekends 
Home E-mail      Work E-mail 
Drivers License Number               Drivers License State 
In addition to my new Savings Account, please open the following accounts:
Young Investor Basic Checking
Student Checking Term Share
ATM Card: No. of Cards Desired 

Credit Report Information

 that the financial institution obtain credit reports on me/us from time to time. I/We understand that the financial institution will use the credit reports in evaluating my/our credit worthiness for various credit products offered by the institution.

Certification and Agreement

(1) The number(s) shown in this application is/are the correct taxpayer identification number(s) and I/we am/are not subject to backup withholding either because I/we have not been notified that I/we am/are subject to backup withholding as a result of failure to report all interest or dividends, or the IRS has notified me/us that I/we am/are no longer subject to backup withholding.   

(2)  by the IRS that I/we am/are subject to backup withholding due to notified payee underreporting and I/we have been notified that the backup withholding is terminated. 

(3) I / We agree to be bound by the provisions of the applicable disclosure(s) for products I/we have selected.This financial institution will furnish such applicable disclosure(s) to me/us within the timeframe(s) prescribed by regulation and I/we will inform this financial institution if I/we do not receive full disclosure(s).

 

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