IMPORTANT INFORMATION ABOUT PROCEDURES FOR …

1 Member Services RequestTo help the government fight the funding of terrorism and money laundering activities, federal law requires all financialinstitutions to obtain, verify, and record INFORMATION that identifies each person when opening a new this means for you: When you open an account, we will ask for your name, address, date of birth, and otherinformation that will allow us to identify you. We may also ask to see your driver's license or other identifyingdocuments. MEMBER/OWNER INFORMATIONID Type:Member/Owner Name:SSN/TIN:Mailing Address:Primary Phone:City/State/Zip:ID Number:ID Issuing State:City/State/Zip:ID Exp. Date:E-Mail:Security Code:Employer:Occupation/Title:ID Issuing Date:Date of Birth:Physical Address:Primary Phone:Physical Address:Primary Phone:Name #2:SSN/TIN:Mailing Address:ID Type:Name #1:SSN/TIN:Mailing Address:ID Type:City/State/Zip:City/State/Zip:ID Number:ID Number:ID Issuing State:ID Exp.

2 Date:ID Issuing State:ID Exp. Date:ID Issuing Date:Date of Birth:ID Issuing Date:Date of Birth:City/State/Zip:Joint OwnerAddCUNA Mutual Group 2008, 10-12, 14 All Rights ReservedDOHYI1 (DXX104)-eOther Authorized Signer (Describe): _____AgentSee Account Authorization CardCity/State/Zip:NEWUPDATEIMPORTANT INFORMATION ABOUT PROCEDURES FOR OPENING A NEW ACCOUNTDATE: _____ACCOUNT OWNERSHIPU pdateMEMBER NO: _____Physical Address:The IRS-required certifications set forth in the "TIN CERTIFICATION AND BACKUP WITHHOLDING INFORMATION "section apply to the member/owner listed Phone:RemoveSecurity Code:UpdateOccupation/Title:Work Phone:E-Mail:Employer:JOINT OWNER/AUTHORIZED SIGNER INFORMATIOND esignate the ownership of the accounts and responsibility for the services Account with Rights of SurvivorshipJoint Account without Rights of SurvivorshipJoint OwnerOther Authorized Signer (Describe): _____AddUTMA/UGMA CustodianAgentRemoveSee Account Authorization CardSecurity Code:UpdateOccupation/Title:Work Phone:E-Mail:Employer:HomeCellHomeCellHo meCellPayable on Death (POD)/Trust AccountBeneficiary/POD Payee:Street:Beneficiary/POD Payee:Street:UTMA/UGMA Signature:Date:TIN CERTIFICATION AND BACKUP WITHHOLDING INFORMATIONCity/State/Zip:Designate Specific Accounts:Name of Agent: _____City/State/Zip:All AccountsAll Accounts Designate Specific Accounts: _____Physical Address:Primary Phone:Name #3:SSN/TIN.

3 Mailing Address:ID Type:City/State/Zip:ID Number:ID Issuing State:ID Exp. Date:ID Issuing Date:Date of Birth:City/State/Zip:Joint OwnerOther Authorized Signer (Describe): _____AddAddAgentRemoveSee Account Authorization CardSecurity Code:UpdateOccupation/Title:Work Phone:E-Mail:Employer:ACCOUNT TYPESS hare/Savings:Mobile Banking:Overdraft Protection Indicate transfer priority:AddShare Draft/Checking:AddShare Certificate/Certificate:Money Market:RemoveAudio Response:1. _____ACCOUNT DESIGNATIONSD ebit Card:Other:Remove2. _____4. _____AddRemoveAddRemoveAddRemoveACCOUNT SERVICESAddRemoveAddRemoveAddBill Payment:Remove3. _____AddRemoveInternet Banking:AddRemoveSSN/TIN:Date of Birth:AddRemoveUpdateSSN/TIN:Date of Birth:_____ (as custodian for _____ (minor) under the Uniform Transfers/Gifts to Minors Act.)

4 Minor's SSN/TIN: _____AgencyRemoveUpdateJOINT OWNER/AUTHORIZED SIGNER INFORMATION (continued)DOHYI1 (DXX104)-eHomeCellOther: Other:AddRemoveUpdateAddRemoveUnder penalties of perjury, I certify that:(1) The number shown on this form is my correct taxpayer identification number (or I am waiting for a number to be issued), and(2) I am not subject to backup withholding because: (a) I am exempt from backup withholding, or (b) I have not been notified bythe Internal Revenue Service (IRS) that I am subject to backup withholding as a result of a failure to report all interest ordividends, or (c) the IRS has notified me that I am no longer subject to backup withholding, and(3) I am a citizen or other person. For federal tax purposes, you are considered a person if you are: an individualwho is a citizen or resident alien; a partnership, corporation, company, or association created or organized in theUnited States or under the laws of the United States; an estate (other than a foreign estate); or a domestic trust (as defined inRegulations Section ).

5 (4) The FATCA code(s) entered on this form (if any) indicating that I am exempt from FATCA reporting is the box for item 2 above if you have been notified by the IRS that you are currently subject to backupwithholding because you have failed to report all interest and dividends on your tax return. By checking this box, this serves to strikeout the language related to underreporting. Complete a W-8 BEN if you are not a person. If a W-8 BEN is completed, your signaturedoes not serve to certify this payee code (if any)Exemption from FATCA reporting code (if any)FOR CREDIT UNION USE ONLYDate of Membership: _____Adjustment From:_____Membership Eligibility: _____Other _____Passport AUTHORIZATIONXM ember/OwnerDateBy 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 CreditUnion makes from time to time which are incorporated herein.

6 I/We acknowledge receipt of the agreements and disclosures applicableto the accounts and services requested herein. If an access card or EFT service is requested and provided, I/we agree to the terms ofand acknowledge receipt of the Electronic Fund Transfers Agreement and Disclosure. All of the terms, conditions, form of accountownership, account selection and other INFORMATION indicated on this document applies to all of the accounts listed unless the creditunion is notified in writing of a change. I/We agree that any updates identified herein amend the previously signed Member ServicesRequest(s), and are subject to the terms and conditions of the applicable disclosures noted Internal Revenue Service does not require your consent to any provision of this document other than the certifications required toavoid backup Owner/Authorized SignerDateXJoint Owner/Authorized SignerDateXJoint Owner/Authorized SignerDateCheck Verify/OFAC:DOHYI1 (DXX104)-eMember Verification: Credit CardOther: _____Credit ReportReg GGYesYesNoOpened/Approved By: _____Other _____Member/Owner Primary Photo: Secondary ID:NoSocial Security Card Note:_____Member/Owner RecordJoint Owner(s) RecordState IDDrivers Lic.

7 Other _____Secondary ID:Credit CardSocial Security Card Overdraft Protection Opt-In Date:_____Drivers Lic. Joint Owner(s) Primary Photo: Other _____Passport State ID