Painesville Credit Union -- Secure Loan Form



	Membership Application Form 280 N. St Clair Street, Painesville, OH 44077 Phone: 440-352-8974 • Fax: 440-352-8110

Eligibility

To take advantage of the many services offered by the credit union, you must open a share account. Simply complete a membership form and submit it. PCU complies with the USA PATRIOT Act (Uniting and Strengthening America by Providing Appropriate Tools Required to Intercept and Obstruct Terrorism) which requires the following information prior to the opening of a new member account; Name of individual or business, Photo Identification, Date of Birth, Address, Social Security Number. For non-citizens a passport, alien ID card, or Gov't issued photo ID will suffice. Other security information such as date of birth and mother's maiden name will be obtained on that card.

Membership Field

Anyone who lives, works, worships, or attends school in Lake County.

Please complete the form and submit.

Personal Account

First Name:
Middle Name or Initial:
Last Name:
Your Email Address:
Street Address:
City:
State:	Zip:
Home Phone #:
Social Security #:
TIN# (Business) :

Type of Ownership

Type:	Individual Joint
If Joint, other Owner:

Business Account

Resolution:	Individual Joint
Type of Entity:	Corporation Association Club Sole Proprietorship Partnership Nonprofit Organization Other

Submit Application

I hereby make application for membership in and agree to conform to the Bylaws, as amended, of the Painesville Credit Union (the "Credit Union"). I certify that:

I am within the field of membership of this Credit Union. The information provided on this application is true and correct.

Employer:

Business Phone:

Membership Eligibility:

Membership Application Form

280 N. St Clair Street, Painesville, OH 44077 Phone: 440-352-8974 • Fax: 440-352-8110

280 N. St Clair Street, Painesville, OH 44077
Phone: 440-352-8974 • Fax: 440-352-8110