Northwest Federal Credit Union
Additional Services Application
for Current Members
Account Number
Full Name
Social Security #    Date of Birth
Address Apt#
City State   Zip
Home Phone#  Work Phone# Ext.
Email
Mother's Maiden Name
I would like to apply for the following Northwest Resource FCU accounts or services (check all that apply):

 Premium Checking Account ($25.00 minimum opening balance) - Debit Card PIN# (4 digits)
Value Checking Account ($25.00 minimum opening balance) - ATM Card Pin# (4 digits)
Money Market Savings Account ($2,500 minimum balance)
Certificate Account ($500 minimum balance) Term: Amount:
Traditional IRA ($25 minimum opening balance)
Roth IRA ($25 minimum opening balance)
Education IRA ($25 minimum opening balance, child must be Primary on account)
Money Builder Certificate ($10 minimum balance, $10 minimum monthly electronic deposit)
Easy Saver Certificate ($10 minimum balance, for children age 19 and younger)
Holiday Club Certificate ($5 minimum balance)
Tax Saver Club Certificate ($5 minimum balance)
Other, Please Specify
Opening Deposit Information:
 
Transfer funds from my account, Share ID
Transfer funds from another NRFCU account: Account Number Share ID:
I have enclosed a check for the full amount needed to open the account(s).

Comments:
Authorization
By signing below, I/We agree to the terms and conditions of the Membership and Account Agreement, Truth-in-Savings Rate and Fee Schedule, Funds Availability Policy Disclosure, if applicable, and to any amendment the Credit Union makes from time to time which are incorporated herein. I/We acknowledge receipt of a copy of the Agreement and Disclosure applicable to the accounts and services requested herein. If an ATM card or EFT service is requested and provided, I/We agree to the terms of and acknowledge receipt of the Electronic Funds Transfer Agreement. The Internal Revenue Services does not require your consent to any provision of this Account Card other than the certifications required to avoid backup withholding.

Member Signature_________________________________________ Date_____________

Joint Member Signature_____________________________________

Joint Member Signature_____________________________________

Please print and sign this completed form and return with your opening deposit(s) to:

Northwest Resource FCU • Attn: New Accounts • PO Box 2788 • Portland, OR 97208