Scott Associates Credit Union Inc. | Secure Membership Form


	Secure Membership Form 14111 Scottslawn Road, Marysville, OH 43041 Phone: (937) 644-7385 • Fax: (937) 645-2749

This is an express application and additional information may be needed to meet your request.

Not sure if you are eligible to join? Click here to see if you qualify»

Important Information about Procedures for Opening a New Account

To help the government fight terrorism funding and money laundering activities. Federal law now requires all financial institutions to obtain, verify and record information that identifies each person who opens an account.

Scott Associates Credit Union Inc. has operational procedures in place to comply with these requirements. 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.

Affiliation or Employment:

First Name:

Middle Name/Initial:

Last Name:

Street Address:

City:

State:

Zip Code:

Home Phone #:

Cell Phone #:

Work Phone #

Ext:

Social Security #:

Birthdate (MM/DD/YYYY):

Email Address: