Authorization for CU Online online banking service

- - - - - - - - - - - - - - - - - PLEASE PRINT AND RETURN TO SAINT AGNES FEDERAL CREDIT UNION - - - - - - - - - - - - - - -

Member Name: _____________________________________________________________________ Member #: ______________________

Address: ______________________________________________________________________________________________________________

City: _____________________________________________________________________________ State: __________ ZIP:_______________

Home Phone: (_______)_________________ Work Phone: (_______)__________________ Cell Phone: (_______)__________________

Email Address: ________________________________________________________________________________________________________
(Required for enrollment notification. Please print legibly to avoid delays.)

________Please sign me up for CU Online (online banking).
All shares and loans under the member number listed above will be accessible.


Other accounts I wish to transfer into are:

Name: ____________________________________________________________________________ Member #:_________________________

Name: ____________________________________________________________________________ Member #:_________________________

Name: ____________________________________________________________________________ Member #:_________________________

If you have a Saint Agnes checking account, you can enroll in our Bill Pay service. After you've logged in to CU Online, click on the Bill Payer button to get started.

I agree to receive all agreements and initial disclosures electronically. After I have carefully read the agreement in its entirety, I will be asked to consent to the terms and conditions of the agreement.

Signature:________________________________________________________________________ Date: _______________________________
(Member only must sign.)

Please drop off this completed application to either branch office or mail to: Saint Agnes Federal Credit Union, Attn: Marketing Dept., 720-E Maiden Choice Lane, Baltimore, MD 21228, or FAX to 410-869-8293. You will be notified by e-mail when your service is activated.