Open An Account

* Indicates Required

• Account Information

  Provide the information requested below and we will confirm your eligibility for the product(s) you selected.

  USA Patriot Act - Notice

  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 to you

  When you open an Account, Millstream Area CU will ask you for your name, address, date of birth, and other information that will allow us to identify you. We may also ask you to provide identifying documents such as driver's license or other information about you.

  What type of account would you like to open?

  Ownership Type *

  Individual Account Joint Account

  Ownership Type is required

  Account Type *

  Basic Checking Teen Checking Senior Checking Fresh Start Checking Share Savings Kids Club Savings Money Market Certificate Individual Retirement Account (IRA) Christmas Club Account Special Savings Account

  Account Type is required
• Step 2

  Tell us about you

  Your Name

  First Name *

  Middle Initial

  Last Name *

  Where do you live?

  Address *

  Address Line 2

  City *

  State *

  Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming

  Zip *

  Contact Information

  Primary Phone *

  Work Phone *

  Email *

  You must provide a valid email address to complete your application. We ask for your email address so we can send you important communications relating to your application. Please see our Privacy Policy for more details.

  How would you prefer we contact you? *

  Primary Phone Work Phone Email

  Preferred Contact Method is required
• Step 3

  Identifying Information

  We need this information to verify your identity. Information passed through this form is secure.

  Date of Birth *

  Social Security Number *

  Government Issued Photo ID *

  Driver's License Passport State-Issued ID Card U.S. Government ID

  ID Number *

  Drivers License State

  Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming

  Issue Date *

  Expiration Date *
• Step 4

  Joint Applicant Information

  We also need information about your Joint Applicant! The next few pages (with "Joint Applicant Information" at the top) ask questions about your Joint Applicant.

  Tell us about you

  Your Name

  First Name *

  Middle Initial

  Last Name *

  Where do you live?

  Address *

  Address Line 2

  City *

  State *

  Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming

  Zip *

  Contact Information

  Primary Phone *

  Work Phone *

  Email *

  You must provide a valid email address to complete your application. We ask for your email address so we can send you important communications relating to your application. Please see our Privacy Policy for more details.

  How would you prefer we contact you? *

  Primary Phone Work Phone Email

  Preferred Contact Method is required
• Step 5

  Joint Applicant Information

  Identifying Information

  We need this information to verify your identity. Information passed through this form is secure.

  Date of Birth *

  Social Security Number *

  Government Issued Photo ID *

  Driver's License Passport State-Issued ID Card U.S. Government ID

  ID Number *

  Drivers License State

  Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming

  Issue Date *

  Expiration Date *

• Beneficiary Informtion

  The owners of many accounts name payable-on-death (POD) beneficiaries for the accounts. That means that when the account owner (or the last surviving owner, in the case of a joint account) dies, the POD beneficiary can simply claim the money from the Credit Union. The deceased person's will does not come into play, and there's no need for any probate court involvement, either.

  POD designations are widely used because they're simple both for the person who sets them up and the beneficiaries who inherit. Please indicate below if you would like to include a beneficiary at this time.

  Would you like to designate a beneficiary? *

  Yes I do not wish to name a beneficiary at this time

  Whether you wish to designate a beneficiary is required

  Beneficiary #1

  Beneficiary First Name

  Beneficiary Last Name

  Beneficiary Relationship

  Beneficiary Address

  Beneficiary Address 2

  Beneficiary City

  Beneficiary State

  Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming

  Beneficiary Zip

  Beneficiary Social Security Number

  Beneficiary Date of Birth

  Beneficiary #2

  Beneficiary First Name

  Beneficiary Last Name

  Beneficiary Relationship

  Beneficiary Address

  Beneficiary Address 2

  Beneficiary City

  Beneficiary State

  Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming

  Beneficiary Zip

  Beneficiary Social Security Number

  Beneficiary Date of Birth

  Beneficiary #3

  Beneficiary First Name

  Beneficiary Last Name

  Beneficiary Relationship

  Beneficiary Address

  Beneficiary Address 2

  Beneficiary City

  Beneficiary State

  Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming

  Beneficiary Zip

  Beneficiary Social Security Number

  Beneficiary Date of Birth

  Beneficiary #4

  Beneficiary First Name

  Beneficiary Last Name

  Beneficiary Relationship

  Beneficiary Address

  Beneficiary Address 2

  Beneficiary City

  Beneficiary State

  Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming

  Beneficiary Zip

  Beneficiary Social Security Number

  Beneficiary Date of Birth

  Beneficiary #5

  Beneficiary First Name

  Beneficiary Last Name

  Beneficiary Relationship

  Beneficiary Address

  Beneficiary Address 2

  Beneficiary City

  Beneficiary State

  Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming

  Beneficiary Zip

  Beneficiary Social Security Number

  Beneficiary Date of Birth

• Security Questions

  Please set two security questions. These questions may be asked at any time by a Millstream Area CU employee to verify your identity.

  Security Question 1

  Select a security question *

  Select One What is your favorite movie? What is the name of your first pet? What is your favorite color? What did you want to be when you grew up? Mother's maiden name? Create Custom Question

  Custom Question *

  Security question 1 answer *

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  Security Question 2

  Select a security question *

  Select One What is your favorite movie? What is the name of your first pet? What is your favorite color? What did you want to be when you grew up? Mother's maiden name? Create Custom Question

  Custom Question *

  Security question 2 answer *

  
  

• Authorization & Signature

  To complete the account opening process, you must stop by a Millstream Area CU location with your government-issued photo ID.

  I will complete my account opening at *

  Western Ave. Office Fostoria Ave. Office North Baltimore Office

  Please select where you will complete your account opening

  Authorization *

  As part of the account opening process, Millstream Area CU will obtain information about you from a consumer reporting agency. Based on that information, you may or may not be approved to open the account. I authorize Millstream Area CU to access consumer reports for me and any joint applicants in order to process this application.

  Authorization is required

  Signature

  By filling in the date below, you confirm all information provided is accurate and complete to the best of your knowledge.

  Primary Applicant Date *

  Joint Applicant Date *

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