Questa Credit Union Home Page

Membership Form

2433 Highway 522, Questa, NM 87556
Phone: (575) 586-0423

How To Join

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 when opening a new account. 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.
Under penalties or perjury, I certify that the number shown on this form is my correct taxpayer identification number and that I am not subject to Backup Withholding either because I have not been notified that I am subject to back up withholding as a result of a failure to report all interest or dividends, OR The Internal Revenue Service has notified me that I am no longer subject to backup withholding, and I am a U.S. Citizen (including U.S. resident alien).

How to join qcu:

  1. Complete the following online Membership Application Request Form and submit when complete.
  2. Upload a copy of your valid Driver’s License or Government Issued ID, by secure e-mail, “Send Secure Document”. For joint account, joint owner must upload a copy of his/her valid ID.
  3. Once the Government issued ID and Membership Application are received, we will send you the pre-filled application for signature. Your signature will be recorded electronically.
  4. A $26.00 required minimum deposit is required to fund your savings account. Accounts not funded in 30 days will be closed. Complete the Funding Membership section to process the required minimum deposit.
I qualify for membership by one of the following:
 
 



Applicant Information
First Name: MI: Physical Address :
Last Name: City : State:
Date of Birth: Zip :
Mother's Maiden Name: Mailing Address :
Social Security #: City : State:
Driver’s License # : Zip :
Driver License Issue Date : Home Phone :
Driver License Expiration Date : Mobile Phone :
Driver License State of Issue : Business Phone :
Email Address : Employer:
    Occupation / Title:

Joint Applicant Information
First Name: MI: Physical Address :
Last Name: City : State:
Date of Birth: Zip :
Mother's Maiden Name: Mailing Address :
Social Security #: City : State:
Driver’s License # : Zip :
Driver License Issue Date : Home Phone :
Driver License Expiration Date : Mobile Phone :
Driver License State of Issue : Business Phone :
Email Address : Employer:
    Occupation / Title:

Beneficiary(s) (OPTIONAL)
Name Social Security Relationship Date of Birth Address

















How did you hear about us?
Web Site
Friend / Family -   Name:
Member/Co-Worker -  Name:
Other:

Funding Membership (ACH)
Financial Institution Name Routing & Transit Number:
Account Number: Amount:

I, hereby authorize Questa Credit Union (QCU) to initiate a one-time debit entry to my account(s) at the depository financial institution named above. I acknowledge that the origination of ACH transactions to my account must comply under the rules of the National Automated Clearing House Association (NACHA) and with the provisions of U.S. Law. Authorization will require funds to be available in the account to allow reasonable time for processing on the requested date. Entries returned due to non-sufficient funds may be charged a fee, as set forth in QCU’s Fee Schedule. This authorization will remain in full force and effect until qcu has received funds. Funds will be applied directly to the new share account.


Submit Application

To avoid delays in processing your request, please provide us with the best method and time to contact you. Best method of contact:
 Home Phone      Mobile Phone      Work Phone              What time of day is best to call:


By signing or otherwise authenticating, I/we agree to the terms and conditions of the Membership and Account Agreement Truth-in-Savings Disclosure, Privacy Disclosure, 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 the agreements and disclosures applicable to the accounts and services requested herein. If an access card or EFT service is requested and provided, I/We agree to the terms of and acknowledge receipt of the Electronic Fund Transfers Agreement and Disclosure. All of the terms, conditions, form of account ownership, account selection and other information indicated on this document applies to all of the accounts listed useless the Credit Union is notified in writing of a change. I/We agree that any updates identified herein amend the previously signed Member Services Request(s) and are subject to the terms and conditions of the applicable disclosures noted above.

By clicking submit I/We agree to apply for an account and do business electronically. Clicking submit authorizes the Questa Credit Union to contact us to originate an account. By clicking submit, we agree to the terms above.

Date:
 Primary Signature:
 Joint Signature: