I hereby make application for VISA® Debit Card and agree to the terms and conditions set forth in the Electronic Funds Transfer Disclosure relating to the use of my card(s). I AGREE NOT TO GIVE ANY PERSON MY PERSONAL IDENTIFICATION NUMBER (PIN) NOR KEEP MY CARD AND PIN NUMBER IN THE SAME LOCATION. I understand that I will be liable in accordance with the disclosure and that the use of my card(s) and PIN number will give access to my savings and checking account.
Pin selection should not be any of the following: Birthday, S.S #, address, telephone, same numbers or obvious numbers such as 1234. You should memorize your PIN # and destroy any paper which contains it.
Joint Signature ______________________________________ Date _________________
Do not write below this line / CU use only
Primary Member Identification: ________________________ (i.e. drivers lic., passport, etc.)
Joint Member Identification: ___________________________ (i.e., drivers lic., passport, etc.)
Former Acct# (if applicable) _____________ Former Name (if applicable) __________________________
SFEFCU Rep: _________________________