Automated Teller Machine (ATM) Card Application

Instructions:

1. Print this application.
2. Complete the application. If you are requesting two cards, both applicants must sign.
3. Mail the application to:
   • Michigan Educational Credit Union
     9200 Haggerty Road
     Plymouth, MI 48170
4. Upon approval, you will receive your ATM card in the mail. Your ATM PIN (Personal Identification Number) will be mailed to you separate from the ATM card.

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Automated Teller Machine (ATM) Card Application Form		Michigan Educational Credit Union
Please prepare an Automated Teller Machine (ATM) card for use with my account at Michigan Educational Credit Union. You have my permission to check my credit history. I realize I must be at least 18 years of age and a member in good standing. I am requesting access to my overdraft line-of-credit (applies only to those members with a DraftlChecking account).

Name

Credit Union Account Number:

Mailing Address:

City/State/ Zip Code:

Home Telephone:

Business Telephone:

Social Security No.

Date of Birth:

Employer 's Name:

Employer 's Address:

Withdrawals limited to $500.00 per day.

To obtain additional cards for joint owners on your account, complete this section:

Name:

Mailing Address (if different):

City/State/ Zip Code:

Social Security No.

Date of Birth:

Employer 's Name:

Employer 's Address:

I/We agree to ...   All terms and conditions which were in effect on the original agreements of the accounts to which I/we will have access through this ATM Card;   Any amendments to these agreements which may be made from time to time;   All terms and conditions which will accompany the ATM Card; Use of your ATM card will constitute proof of your acceptance of these terms and conditions.

Sign Here:	Date:
Second Applicant Signature:	Date:

Duplicate cards $2 each. Duplicate PINs $2 each. All ATM applications subject to Credit Union approval.