member no: important information about procedures … · above, advertising and telemarketing calls...

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© CUNA Mutual Group 2008, 10-12, 14 All Rights Reserved 01201196-DX100-C-1-042817 (DX1004)-e Member Services Request NEW UPDATE DATE: MEMBER NO: IMPORTANT INFORMATION ABOUT PROCEDURES FOR OPENING A NEW ACCOUNT 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. MEMBER/OWNER INFORMATION Update Member/Owner Name: SSN/TIN: Mailing Address: ID Type: City/State/Zip: ID Number: Physical Address: ID Issuing State: ID Issuing Date: City/State/Zip: ID Exp. Date: Date of Birth: Home Phone: Cell Phone: E-Mail: Work Phone: Mother's Maiden Name: Employer: Occupation/Title: The IRS-required certifications set forth in the “TIN CERTIFICATION AND BACKUP WITHHOLDING INFORMATION” section apply to the member/owner listed above. ACCOUNT OWNERSHIP Designate the ownership of the accounts and responsibility for the services requested. Individual Joint Account with Rights of Survivorship Joint Account without Rights of Survivorship JOINT OWNER/AUTHORIZED SIGNER INFORMATION Joint Owner UTMA/UGMA Custodian Agent Other Authorized Signer (Describe): Add Update Remove See Account Authorization Card Name #1: SSN/TIN: Mailing Address: ID Type: City/State/Zip: ID Number: Physical Address: ID Issuing State: ID Issuing Date: City/State/Zip: ID Exp. Date: Date of Birth: Home Phone: Cell Phone: E-Mail: Work Phone: Mother's Maiden Name: Employer: Occupation/Title: Joint Owner Agent Other Authorized Signer (Describe): Add Update Remove See Account Authorization Card Name #2: SSN/TIN: Mailing Address: ID Type: City/State/Zip: ID Number: Physical Address: ID Issuing State: ID Issuing Date: City/State/Zip: ID Exp. Date: Date of Birth: Home Phone: Cell Phone: E-Mail: Work Phone: Mother's Maiden Name: Employer: Occupation/Title:

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Page 1: MEMBER NO: IMPORTANT INFORMATION ABOUT PROCEDURES … · above, advertising and telemarketing calls and text message(s) using an automatic telephone dialing system and/or an artificial

© CUNA Mutual Group 2008, 10-12, 14 All Rights Reserved 01201196-DX100-C-1-042817 (DX1004)-e

Member Services Request NEW UPDATE DATE: MEMBER NO:

IMPORTANT INFORMATION ABOUT PROCEDURES FOR OPENING A NEW ACCOUNT

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.

MEMBER/OWNER INFORMATION

Update

Member/Owner Name: SSN/TIN:

Mailing Address: ID Type:

City/State/Zip: ID Number:

Physical Address: ID Issuing State: ID Issuing Date:

City/State/Zip: ID Exp. Date: Date of Birth:

Home Phone: Cell Phone: E-Mail:

Work Phone: Mother's Maiden Name:

Employer: Occupation/Title:

The IRS-required certifications set forth in the “TIN CERTIFICATION AND BACKUP WITHHOLDING INFORMATION” section apply to the member/owner listed above.

ACCOUNT OWNERSHIP Designate the ownership of the accounts and responsibility for the services requested.

Individual Joint Account with Rights of Survivorship Joint Account without Rights of Survivorship

JOINT OWNER/AUTHORIZED SIGNER INFORMATION

Joint Owner UTMA/UGMA Custodian Agent Other Authorized Signer (Describe): Add Update Remove See Account Authorization Card

Name #1: SSN/TIN:

Mailing Address: ID Type:

City/State/Zip: ID Number:

Physical Address: ID Issuing State: ID Issuing Date:

City/State/Zip: ID Exp. Date: Date of Birth:

Home Phone: Cell Phone: E-Mail:

Work Phone: Mother's Maiden Name:

Employer: Occupation/Title:

Joint Owner Agent Other Authorized Signer (Describe): Add Update Remove See Account Authorization Card

Name #2: SSN/TIN:

Mailing Address: ID Type:

City/State/Zip: ID Number:

Physical Address: ID Issuing State: ID Issuing Date:

City/State/Zip: ID Exp. Date: Date of Birth:

Home Phone: Cell Phone: E-Mail:

Work Phone: Mother's Maiden Name:

Employer: Occupation/Title:

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Page 2: MEMBER NO: IMPORTANT INFORMATION ABOUT PROCEDURES … · above, advertising and telemarketing calls and text message(s) using an automatic telephone dialing system and/or an artificial

01201196-DX100-C-1-042817 (DX1004)-e

JOINT OWNER/AUTHORIZED SIGNER INFORMATION (continued)

Joint Owner Agent Other Authorized Signer (Describe): Add Update Remove See Account Authorization Card

Name #3: SSN/TIN:

Mailing Address: ID Type:

City/State/Zip: ID Number:

Physical Address: ID Issuing State: ID Issuing Date:

City/State/Zip: ID Exp. Date: Date of Birth:

Home Phone: Cell Phone: E-Mail:

Work Phone: Mother's Maiden Name:

Employer: Occupation/Title:

ACCOUNT TYPES

Share/Savings: Add Remove Money Market: Add Remove Share Draft/Checking: Add Remove Other: Add Remove Share Certificate/Certificate: Add Remove Other: Add Remove

ACCOUNT SERVICES

Debit Card: Add Remove Overdraft Protection Update

Indicate transfer priority:

1.

2.

3.

4.

Audio Response: Add Remove

Internet Banking: Add Remove

Mobile Banking: Add Remove

Bill Payment: Add Remove

Other: Add Remove

ACCOUNT DESIGNATIONS

Payable on Death (POD)/Trust Account All Accounts Designate Specific Accounts:

Add Update Remove Add Update Remove

Beneficiary/POD Payee: Beneficiary/POD Payee:

SSN/TIN: Date of Birth: SSN/TIN: Date of Birth:

Street: Street:

City/State/Zip: City/State/Zip:

UTMA/UGMA

(as custodian for (minor)

under the Uniform Transfers/Gifts to Minors Act.) Minor’s SSN/TIN:

Agency

Name of Agent:

Signature: Date:

All Accounts Designate Specific Accounts:

TIN CERTIFICATION AND BACKUP WITHHOLDING INFORMATION Under 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 U.S. citizen or other U.S. person. For federal tax purposes, you are considered a U.S. person if you are: an individualwho is a U.S. citizen or U.S. 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 301.7701-7).

(4) The FATCA code(s) entered on this form (if any) indicating that I am exempt from FATCA reporting is correct.

Certification Instructions. Check 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 strike out thelanguage related to underreporting. Complete a W-8 BEN if you are not a U.S. person. If a W-8 BEN is completed, your signature does not serve to certify this section.

Exempt payee code (if any) Exemption from FATCA reporting code (if any)

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Page 3: MEMBER NO: IMPORTANT INFORMATION ABOUT PROCEDURES … · above, advertising and telemarketing calls and text message(s) using an automatic telephone dialing system and/or an artificial

01201196-DX100-C-1-042817 (DX1004)-e

CONSENT TO CONTACT By signing below, you authorize United Credit union to deliver or cause to be delivered to you at the telephone numbers providedabove, advertising and telemarketing calls and text message(s) using an automatic telephone dialing system and/or an artificial or prerecorded voice. YOU ARE NOT REQUIRED TO SIGN THIS AUTHORIZATION OR ENTER INTO THIS AGREEMENT AS A CONDITION OF PURCHASING ANY PROPERTY, GOODS OR SERVICES. You may withdraw the consent provided herein at any time by providing writtennotice to us at 4444 S. Pulaski Rd., Chicago, IL 60632-4011, by email to [email protected], via phone at 1-800-848-3444, or by any other reasonable means.

Member/Owner Date

X

Joint Owner/Authorized Signer Date

X

Joint Owner/Authorized Signer Date

X

Joint Owner/Authorized Signer Date

X

By executing this Member Services Request, you agree we and/or our third-party debt collectors may contact you by telephone or text messageat any telephone number associated with your account, including wireless telephone numbers (i.e. cell phone numbers) which could result in charges to you, in order to service your account or collect any amounts owed to us, excluding any contacts for advertising and telemarketingpurposes as prescribed by law. You further agree methods of contact may include use of pre-recorded or artificial voice messages, and/or use of an automatic dialing device. You may withdraw consent to be contacted on your wireless telephone number(s) at any time by providingwritten notice to us at 4444 S. Pulaski Rd., Chicago, IL 60632-4011, by email to [email protected], via phone at 1-800-848-3444, or by any other reasonable means. If you have provided a wireless telephone number(s) on or in connection with this Member Services Request,you represent and agree you are the wireless subscriber or customary user with respect to the wireless telephone number(s) provided and havethe authority to give this consent. Furthermore, you agree to notify us of any change to the wireless telephone number(s) for which you areproviding your consent to be contacted.

In order to help mitigate harm to you and your account, we may contact you on any telephone number associated with your account, including a wireless telephone number (i.e. cell phone number), to deliver to you any messages related to suspected or actual fraudulent activity on youraccount, data security breaches or identity theft following a data breach, money transfers or any other exigent messages permitted by applicable law. These contacts will not contain any telemarketing, cross-marketing, solicitation, advertising, or debt collection message of any kind. Thecontacts will be concise and limited in frequency as required by law. You will have an opportunity to opt-out of such communications at the timeof delivery.

AUTHORIZATION 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 unless 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.

The Internal Revenue Service does not require your consent to any provision of this document other than the certifications required to avoid backup withholding.

Member/Owner Date

X

Joint Owner/Authorized Signer Date

X

Joint Owner/Authorized Signer Date

X

Joint Owner/Authorized Signer Date

X

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Page 4: MEMBER NO: IMPORTANT INFORMATION ABOUT PROCEDURES … · above, advertising and telemarketing calls and text message(s) using an automatic telephone dialing system and/or an artificial

01201196-DX100-C-1-042817 (DX1004)-e

PROXY STATEMENT Known by all these present, that the undersigned shareholder of the United Credit Union hereby constitutes and appoints the member of the Board of Directors of the United Credit Union of Chicago Illinois, an Illinois Corporation, and each of them, my true and lawful attorneys, agentsand proxies, to act for me and in my stead at any annual meeting and at any special meetings of the shareholders of United Credit Union, or adjournment of any of said meetings and for me and in my name, place and stead to vote all shares in said United Credit Union, or adjournment of any of said meetings and for me and in name, place and stead to vote all shares in said United Credit Union which I am entitled to vote in the election of directors of said United Credit Union and to take part in the transaction of such other business as may properly come before saidmeetings, as fully as I could do if personally present. A Majority of such of the above said attorneys, agents and proxies as shall be present and shall act at said meetings for, if only one shall be present and act, then that one shall have and exercise all the powers of all of the attorneys,agents and proxies hereunder, or said attorneys, agents and proxies; or majority of them, may appoint one or more persons as substitute orsubstitutes who may vote and act with all the powers of all of said attorneys, agents, or proxies hereunder. This proxy shall be in full force and effect until revoked by me in writing.

Signature of Member Date

X

FOR CREDIT UNION USE ONLY Date of Membership: Opened/Approved By: Membership Eligibility:

Member Verification:

Verification List(s) Checked: OFAC Other:

List Verification Completion Date: By:

Reports Checked: Credit Report Check Verification Report Other:

Overdraft Protection Opt-in Completion Date:

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Page 5: MEMBER NO: IMPORTANT INFORMATION ABOUT PROCEDURES … · above, advertising and telemarketing calls and text message(s) using an automatic telephone dialing system and/or an artificial

MEMBER IDENTITY INFORMATION& VERIFICATION CARD

MEMBER IDENTITY INFORMATION

IMPORTANT INFORMATION ABOUT PROCEDURES FOR OPENING A NEW ACCOUNT

To help the government fight the funding of terrorism and money laundering activities, Federal law requires all financial institutions toobtain, verify, and record information that identifies each person who opens an account.

What this means to you: When you open an account, we ask for your name, address, date of birth, and other information that willallow us to identify you. We may also ask to see your driver's license or other identifying documents.

Member/Owner ___________________________________________________________ Member No. ____________________ Date of Birth _______________

Mailing Address ___________________________________________________________ City/State/Zip ________________________________________________

Business

Residence Physical Address ___________________________________________________________________________________(if different thanaddress given above)

Occupation (for individual) _____________________________________ Employer _______________________________________________________________

Nature of Business (for business) _________________________________________________________________________________________________________

GOVERNMENT ISSUED IDENTIFICATION NUMBER

SSN/EIN ________________________________________________________

Individual Taxpayer Identification Number ___________________________

If you do not have a SSN/EIN you must provide AT LEAST ONE of the following:

Alien Identification Number ______________________________________

Describe Document:___________________________________________________________________________________________________________________

______________________________________________________________________________________________________________________________________

Country ___________________________________________________

NOTARY INFORMATION

MEMBER/OWNER

Complete if required by your credit union:

I certify that the information provided above is my true and correct identity information.

Signed ____________________________________________________________________________________________

Passport Number ________________________________________________________ Country ___________________________________________________

DATE

Other Government Issued Document No. ___________________________________(with photograph or similar safeguard)

State of ___________________________, County of _____________________________________________________

City, Town, Village of _______________________________________________________________________________

This person named hereon personally came before me and signed above on this, the ______________________

day of __________________, ______.

My commission expires on _____________.

___________________________________________________________________________________________________

___________________________________________________________________________________________________

NOTARY SIGNATURE

PRINTED NAME

For Notary Seal(or, use this area if

credit union requires a thumb printidentification)

CUNA Mutual Group, 2003 D40000 Rev. 08/03

___________________________________________________________________________________

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Page 6: MEMBER NO: IMPORTANT INFORMATION ABOUT PROCEDURES … · above, advertising and telemarketing calls and text message(s) using an automatic telephone dialing system and/or an artificial

DOCUMENTARY VERIFICATION

FOR CREDIT UNION USE ONLY:

CUNA Mutual Group, 2003 D40000 Rev. 08/03

Driver's License No. _______________________

Individuals

State ___________ Issue Date ______________________________ Exp. Date ____________________

Student ID No. ______________________________________________

Issuing Authority _____________________________________________

School ________________________________________________________________

Passport No. ______________________________ Date ____________ Country ________________________________ Exp. Date ____________________

Employee ID No. _____________________________________________

Issue Date ______________________________

Employer ______________________________________________________________

Exp. Date ____________________

Other Document No. _________________________________________ Describe Document ____________________________________________________

Certified Articles of Incorporation Dated _______________________

Businesses and Other Organizations

State _________________________________________________________________

Partnership Agreement Dated _______________________

Financial Statement of Business (describe business) ______________________________________________________________________________________

Names of Partners ________________________________________________________________

Business License No. ______________________ Date ____________ Issuing Authority ________________________ Exp. Date ____________________

Trust Instrument Dated ____________________ Name of Grantor(s) ________________________________________________________________________

NON-DOCUMENTARY VERIFICATION

Other documents showing existence of entity (describe) __________________________________________________________________________________

Third Party Verification (credit bureaus, public data bases) Source ________________________________________________________________

Obtained References from Other Financial Institutions Name _________________________________________________________________

Contacted Member by: Phone

Other Sources ________________________________________________________________________________________________________________________

Mail E-Mail

DISCREPANCY DOCUMENTATION

State any discrepancy in the identity information provided above discovered through the identity verification process and the resolution of thediscrepancy.

________________________________________________________________________________________________________________________________________

________________________________________________________________________________________________________________________________________

STAFF COMPLETION DOCUMENTATION

Verification Completion Date _____________________________________

Treasury CIP LIST

By ____________________________________________________________________

Government List(s) Checked: OFAC Other: _____________________________________________________________________

By ____________________________________________________________________List Verification Completion Date ______________________________

.

1) Members seeking to open a new account must have their identity verified. An account is a formal banking or business relationship established toprovide services, dealings or financial transactions.

CREDIT UNION TIPS

Examples of products or services that constitute an account are as follows:Opening share, saving, certificate, IRA, or other asset accountsOpening a credit account or other extensions of creditSafety Deposit boxes or other safekeeping services

An account does NOT include:Check cashingWire transferCheck or money order sales.

.. ..

2) If a member does not have a residential or business street address collect the APO (Army Post Office) or FPO (Fleet Post Office) or street addressof next of kin or other contact.

3) If a foreign business does not have a TIN, you must obtain an alternative government issued document certifying the existence of the business orenterprise.

4) If a member does not have a TIN but has applied for a TIN, you may open the account by confirming the application was filed and the membergets the TIN within a reasonable time after the account is opened.

5) When the identity of a business or organization cannot be verified your credit union's Customer Identity Program must contain procedures forobtaining and verifying identity information of individuals with authority or control over the account, including signatories.

6) Credit unions must determine whether the member appears on any list of known or suspected terrorists or terrorist organizations. The lists areissued by a federal government agency and designated by the Treasury Department as a list subject to CIP comparison requirements.

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Page 7: MEMBER NO: IMPORTANT INFORMATION ABOUT PROCEDURES … · above, advertising and telemarketing calls and text message(s) using an automatic telephone dialing system and/or an artificial

MEMBER ACCOUNT NUMBER AMOUNT OF LOAN REQUEST

NAME ADDRESS

1.

2.

3.

1.

2.

3.

CITY STATE HOME PHONE CELL PHONE

HOME PHONE CELL PHONENAME ADDRESS CITY STATE

STATE

NAME (LAST, FIRST, MI)

PRESENT ADDRESS (STREET, CITY, STATE, ZIP) YEARS THERE

YEARS THEREPREVIOUS ADDRESS (STREET, CITY, STATE, ZIP)

SOCIAL SECURITY NUMBER

HOUSING RENT

PRESENT SCHOOL

HOME PHONE CELL PHONE

BIRTH DATE

E-MAIL ADDRESS

POSITION YEARS THERE

GROSS MONTHLY SALARY

OTHER INCOME SOURCES

$

$

TOTAL MONTHLY INCOME $

PHONE

OWN

MORTGAGE/ FINANCED WITH:$

$

$

$

$

$

$

$

$

$

$

$

$

$

$

$

$

$

$

$

RENT/LANDLORD

VEHICLE LOAN/FINANCED WITH:

OTHER DEBTS:

I I . MEMBER APPLIC ANT II I . MEMBER FINANCIAL INFORMATION

IV. REFERENCES

NOT

RELA

TED

PERS

ONS

RELA

TIVE

NOT

LIVI

NG W

ITH

YOU

I am not indebted to any other Credit Union, bank or loan agency either as maker or endorser, except as stated herein. No consideration has passed or will pass from me, as the borrower, to an endorser for his endorsement. The statements herein are made for the purpose of inducing the Credit Union to make a loan. “For the purpose of determin-ing my eligibility for credit, you are authorized to procure consumer reporting agencies and to obtain personal and credit information from persons other than consumer reporting agencies.” I hereby voluntarily represent and warrant to the Credit Union, their, successors, or assigns that I am of legal age to contract, that all of the statements as to my present �nancial responsibility and status as set forth herein this application are complete, true, and correct. I have no Claims, Suits, nor Judgments against me: neither have I been involved in Bankruptcy Proceedings, except as stated herein.

APPLICANT’S SIGNATURE DATE

2019 STRIKE LOAN APPLICATIONI . LOAN INFORMATION

DRIVER LICENSE NUMBER

PRESENT BALANCE

MONTHLY PAYMENT

$300.00

TOM
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Page 8: MEMBER NO: IMPORTANT INFORMATION ABOUT PROCEDURES … · above, advertising and telemarketing calls and text message(s) using an automatic telephone dialing system and/or an artificial

© CUNA Mutual Group 1999, 2000, 01, 02, 03, 04, 06, 08, 2016, 18All Rights Reserved Page 1 of 5 NZX011-E

Loan and Security Agreementsand Disclosure Statement

Covered Borrower Under Military Lending ActFIXED RATE STEP RATE LOAN DATE ACCOUNT NUMBER LOAN NUMBER MATURITY DATEVARIABLE RATE

BORROWER 1 (Name & Address) BORROWER 2 (Name & Address)

BORROWER 3 (Name & Address) BORROWER 4 (Name & Address)

TRUTH IN LENDING DISCLOSURE (‘e’ means an estimate)ANNUAL PERCENTAGE RATE FINANCE CHARGE Amount Financed Total of Payments Total Sale PriceThe cost of Your credit as a yearly rate. The dollar amount the credit

will cost You.The amount of creditprovided to You or onYour behalf.

The amount You will havepaid after You have madeall payments as scheduled.

The total cost of Your purchase on credit is$which includes Your downpayment of

% $ $ $ $ .Your Payment Schedule Will Be: Prepayment: If You pay off early You will not have to

pay a penalty.Required Deposit: The Annual Percentage Rate doesnot take into account Your required deposit, if any.

Number of Payments Amount of Payments When Payments Are Due$

Demand: This obligation has a demand feature.$ All disclosures are based on an assumed

maturity of one year.Property Insurance: You may obtain property insurance from anyone You wantthat is acceptable to the Credit Union. If You get the insurance from the CreditUnion You will pay $

Filing Fees$

Non-Filing Insurance$

Late Charge:

Security: Collateral securing other loans with the Credit Union may also secure this Loan. You are giving a security interest inYour shares and dividends and, if any, Your deposits and interest in the Credit Union; and the Property described below:Collateral Property/Model/Make Year I.D. Number Type Value Key Number

$$$

Other (Describe)Pledge of Shares $ in Account No. $ in Account No.Variable Rate:

See Your contract documents for any additional information about nonpayment, default, and any required repayment in full beforethe scheduled date.

X

5.00% 3.20 300.00 303.20

6

1

50.00 Bi-weekly

3.20X

Beginning 12/20/19

3/13/2020

50

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Credit Union Acct No. Loan No.

Page 2 of 5 NZX011-E

ITEMIZATION OF THE AMOUNT FINANCED (‘e’ means an estimate)Itemization of Amount Financed of Amount Given to You Directly Amount Paid on Your Account Prepaid Finance Charge$ $ $ $Amounts Paid to Others on Your Behalf: (If an amount is marked with an asterisk (*) We will be retaining a portion of the amount.)

$ To $ To$ To $ To$ To $ To$ To $ To$ To $ To$ To $ To$ To $ To

MILITARY LENDING ACT DISCLOSURESFederal law provides important protections to members of the Armed Forces and their dependents relating to extensions ofconsumer credit. In general, the cost of consumer credit to a member of the Armed Forces and his or her dependent may notexceed an annual percentage rate of 36 percent. This rate must include, as applicable to the credit transaction or account: Thecosts associated with credit insurance premiums; fees for ancillary products sold in connection with the credit transaction; anyapplication fee charged (other than certain application fees for specified credit transactions or accounts); and any participationfee charged (other than certain participation fees for a credit card account).

A "Covered Borrower" for purposes of this loan means a consumer who, at the time the consumer becomes obligated on thisloan, is a covered member or a dependent of a covered member as defined by the Military Lending Act. A Covered Borrowerdoes not mean a consumer who (though a Covered Borrower at the time he or she became obligated on this transaction) nolonger is a covered member or a dependent of a covered member as defined by the Military Lending Act.

LOAN AGREEMENTIn this Loan Agreement ("Agreement") all references to "Credit Union", "We", "Our" or "Us" mean the Credit Union whose nameappears above and anyone to whom the Credit Union assigns or transfers this Agreement. All references to "You" or "Your" meaneach person who signs, or otherwise authenticates, this Agreement as a borrower.1. PROMISE TO PAY - You promise to pay $ to the Credit Union plus interest on the unpaid balance until what Youowe has been repaid.For fixed rate loans, the interest rate is % per year.For step-rate loans, the initial interest rate will be % until and then the interest rate will be %until the balance is repaid in full.For variable rate loans, the initial interest rate is % per year and will vary as follows:

Collection Costs:

2. PAYMENTS - You promise to make payments of the amount and at the time shown in the Truth in Lending Disclosure. If this isa variable rate loan, the Promise to Pay section tells You whether, if the interest rate increases, You will have to make morepayments, higher payments, or if the final payment will be a balloon payment. You may prepay any amount without penalty. IfYou prepay any part of what You owe, You are still required to make the regularly scheduled payments, unless We have agreedto a change in the payment schedule. Because this is a simple interest loan, if You do not make payments exactly as scheduled,Your final payment may be more or less than the amount of the final payment that is disclosed. If You elect voluntary paymentprotection, We will either include the premium or program fee(s) in Your payments or extend the term of Your loan. If the term isextended, You will be required to make additional payments of the scheduled amount, until what You owe has been paid. Youpromise to make all payments to the place We choose. If this loan refinances another loan You have with Us, the other loan willbe canceled and refinanced as of the date of this loan. Unless otherwise required by law, payments will be applied to amountsowed in the manner We choose.3. LOAN PROCEEDS BY MAIL - If the proceeds of this loan are mailed to You, interest on this loan begins on the date the loanproceeds are mailed to You.4. SECURITY FOR LOAN - This Agreement is secured by all property described in the "Security" section of the Truth in LendingDisclosure. Property securing other loans You have with Us also secures this loan, unless the property is a dwelling or otherwise

50

300.00 300.00

300.00

5.00

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Credit Union Acct No. Loan No.

Page 3 of 5 NZX011-E

prohibited by federal and/or state law. In addition to Your pledge of shares, We may also have what is known as a statutory lienon all individual and joint accounts You have with Us. A statutory lien means We have the right under federal and/or state law toclaim an interest in Your accounts. Unless otherwise prohibited by federal and/or state law, We can enforce a statutory lienagainst Your shares and dividends and, if any, interest and deposits, in all individual and joint accounts You have with Us tosatisfy any outstanding financial obligation that is due and payable to Us. We may exercise Our right to enforce this lien withoutfurther notice to You, to the extent permitted by law. For all borrowers: You pledge as security for this loan all shares anddividends and, if any, all deposits and interest in all joint and individual accounts You have with the Credit Union now and in thefuture. The statutory lien and/or Your pledge will allow Us to apply the funds in Your account(s) to what You owe whenYou are in default. If a dollar amount and account number are listed in the "Security" section of the Truth in Lending Disclosure,You may not withdraw the amount that has been specifically pledged to secure this loan until the Credit Union agrees to releaseall or part of the pledged amount. The statutory lien and Your pledge do not apply to any Individual Retirement Account or anyother account that would lose special tax treatment under state or federal law if given as security.5. DEFAULT - You will be in default under this Agreement if You do not make a payment of the amount required on or before thedate it is due. You will be in default if You break any promise You made in connection with this loan or if anyone is in defaultunder any security agreement made in connection with this Agreement. You will be in default if You die, file for bankruptcy,become insolvent (that is, unable to pay Your bills and loans as they become due), or if You made any false or misleadingstatements in Your loan application. You will also be in default if something happens that We believe may seriously affect Yourability to repay what You owe under this Agreement or if You are in default under any other loan agreement You have with Us.6. ACTIONS AFTER DEFAULT - When You are in default, We may demand immediate payment of the entire unpaid balanceunder this Agreement. If We demand immediate payment, You will continue to pay interest at the rate provided for in thisAgreement, until what You owe has been repaid. We will also apply against what You owe any shares and/or depositsgiven as security under this Agreement. We may also exercise any other rights given by law when You are in default. UnlessYou are a Covered Borrower under the Military Lending Act, You waive any right You have to receive demand forpayment, notice of intent to demand immediate payment and notice of demand for immediate payment.7. EACH PERSON RESPONSIBLE - Each person who signs, or otherwise authenticates, this Agreement will be individually andjointly responsible for paying the entire amount owed under this Agreement. This means We can enforce Our rights against anyone of You individually or against all of You together.8. LATE CHARGE - If You are late in making a payment, You promise to pay the late charge shown in the Truth in LendingDisclosure. If no late charge is shown, You will not be charged one.9. DELAY IN ENFORCING RIGHTS - We can delay enforcing any of Our rights under this Agreement any number of timeswithout losing the ability to exercise Our rights later. We can enforce this Agreement against Your heirs or legal representatives.10. CONTINUED EFFECTIVENESS - If any part of this Agreement is determined by a court to be unenforceable, the rest willremain in effect.11. NOTICES - Notices will be sent to You at the most recent address You have given Us in writing. Notice to any one of You willbe notice to all.12. USE OF ACCOUNT - You promise to use Your account for consumer (personal, family or household) purposes, unless theCredit Union gives You written permission to use the account also for agricultural or commercial purposes, or to purchase realestate.13. NO ORAL AGREEMENTS -- THIS NOTE CONSTITUTES A "WRITTEN LOAN AGREEMENT" PURSUANT TOSECTION 26.02 OF THE TEXAS BUSINESS AND COMMERCE CODE, IF SUCH SECTION APPLIES. THISWRITTEN LOAN AGREEMENT REPRESENTS THE FINAL AGREEMENT BETWEEN THE PARTIES AND MAYNOT BE CONTRADICTED BY EVIDENCE OF PRIOR, CONTEMPORANEOUS, OR SUBSEQUENT ORALAGREEMENTS OF THE PARTIES. THERE ARE NO UNWRITTEN ORAL AGREEMENTS BETWEEN THEPARTIES.14. The following is required by Vermont law: NOTICE TO COSIGNER: YOUR SIGNATURE ON THIS NOTE MEANS THATYOU ARE EQUALLY LIABLE FOR REPAYMENT OF THIS LOAN. IF THE BORROWER DOES NOT PAY, THE LENDER HASA LEGAL RIGHT TO COLLECT FROM YOU.15. NOTICE TO UTAH BORROWERS: This written Agreement is the final expression of the Agreement between You and theCredit Union. This written Agreement may not be contradicted by evidence of any oral agreement.16. OTHER PROVISIONS -

SECURITY AGREEMENTIn this Security Agreement ("Agreement") all references to "Credit Union", "We", "Our" or "Us" mean the Credit Union whosename appears on this document and anyone to whom the Credit Union assigns or transfers this Agreement. All references to the"Loan" mean the loan described in the Loan Agreement that is part of this document. All references to "You" or "Your" mean anyperson who signs, or otherwise authenticates, this Agreement.1. THE SECURITY FOR THE LOAN - You give Us what is known as a security interest in the Property described in the "Security"section of the Truth in Lending Disclosure that is part of this document ("the Property"). The security interest You give includes allaccessions. Accessions are things which are attached to or installed in the Property now or in the future. The security interestalso includes any replacements for the Property which You buy within 10 days of the Loan and any extensions, renewals orrefinancings of the Loan. It also includes any money You receive from selling the Property or from insurance You have on theProperty. If the value of the Property declines, You promise to give Us more property as security if asked to do so.2. WHAT THE SECURITY INTEREST COVERS/CROSS COLLATERAL PROVISIONS - The security interest secures the Loanand any extensions, renewals or refinancings of the Loan. Unless prohibited by applicable law, the security interest alsosecures any other loans, including any credit card loan, You have now or receive in the future from Us and any other

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Credit Union Acct No. Loan No.

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amounts You owe Us for any reason now or in the future, except any loan secured by Your principal dwelling. If theProperty is household goods as defined by the Federal Trade Commission Credit Practices Rule or Your principal dwelling, theProperty will secure only this Loan and not other loans or amounts You owe Us.3. OWNERSHIP OF THE PROPERTY - You promise that You own the Property or, if this Loan is to buy the Property, Youpromise You will use the Loan proceeds for that purpose. You promise that no one else has any interest in or claim against theProperty that You have not already told Us about. You promise not to sell or lease the Property or to use it as security for a loanwith another creditor until the Loan is repaid. You promise You will allow no other security interest or lien to attach to the Propertyeither by Your actions or by operation of law.4. PROTECTING THE SECURITY INTEREST - If Your state issues a title for the Property, You promise to have Our securityinterest shown on the title. We may have to file what is called a financing statement to protect Our security interest from theclaims of others. You irrevocably authorize Us to execute (on Your behalf), if applicable, and file one or more financing,continuation or amendment statements pursuant to the Uniform Commercial Code (UCC) in a form satisfactory to Us. Youpromise to do whatever else We think is necessary to protect Our security interest in the Property. You also promise to pay allcosts, including but not limited to any attorney fees, We incur in protecting Our security interest and rights in the Property, to theextent permitted by applicable law.5. USE OF PROPERTY - Until the Loan has been paid off, You promise You will: (1) Use the Property carefully and keep it ingood repair. (2) Obtain Our written permission before making major changes to the Property or changing the address where theProperty is kept. (3) Inform Us in writing before changing Your address. (4) Allow Us to inspect the Property. (5) Promptly notifyUs if the Property is damaged, stolen or abused. (6) Not use the Property for any unlawful purpose. (7) Not retitle the Property inanother state without telling Us.6. PROPERTY INSURANCE, TAXES AND FEES - You promise to pay all taxes and fees (like registration fees) due on theProperty and to keep the Property insured against loss and damage. The amount and coverage of the property insurance mustbe acceptable to Us. You may provide the property insurance through a policy You already have, or through a policy You get andpay for. You promise to make the insurance policy payable to Us and to deliver the policy or proof of coverage to Us if asked todo so.If You cancel Your insurance and get a refund, We have a right to the refund. If the Property is lost or damaged, We can use theinsurance settlement to repair the Property or apply it towards what You owe. You authorize Us to endorse any draft or checkwhich may be payable to You in order for Us to collect any refund or benefits due under Your insurance policy.If You do not pay the taxes or fees on the Property when due or keep it insured, We may pay these obligations, but We are notrequired to do so. Any money We spend for taxes, fees or insurance will be added to the unpaid balance of the Loan and You willpay interest on those amounts at the same rate You agreed to pay on the Loan. We may receive payments in connection with theinsurance from a company which provides the insurance. We may monitor Our loans for the purpose of determining whether Youand other borrowers have complied with the insurance requirements of Our loan agreements or may engage others to do so. Theinsurance charge added to the Loan may include (1) the insurance company's payments to Us and (2) the cost of determiningcompliance with the insurance requirements. If We add amounts for taxes, fees or insurance to the unpaid balance of the Loan,We may increase Your payments to pay the amount added within the term of the insurance or term of the Loan.7. INSURANCE NOTICE - If You do not purchase the required property insurance, the insurance We may purchase and chargeYou for will cover only Our interest in the Property. The premium for this insurance may be higher because the insurancecompany may have given Us the right to purchase insurance after uninsured collateral is lost or damaged. The insurance willnot be liability insurance and will not satisfy any state financial responsibility or no fault laws.8. DEFAULT - You will be in default if You break any promise You make or fail to perform any obligation You have under thisAgreement. You will also be in default under this Agreement if the Loan is in default. You will be in default if any Property Youhave given Us as security is repossessed by someone else, seized under a forfeiture or similar law, or if anything else happensthat significantly affects the value of the Property or Our security interest in it.9. WHAT HAPPENS IF YOU ARE IN DEFAULT - When You are in default, We may demand immediate payment of theoutstanding balance of the Loan without giving You advance notice and take possession of the Property. You agree the CreditUnion has the right to take possession of the Property without judicial process if this can be done without breach of the peace. IfWe ask, You promise to deliver the Property at a time and place We choose. If the Property is a motor vehicle or boat, You agreethat We may obtain a key or other device necessary to unlock and operate it, when You are in default. We will not be responsiblefor any other property not covered by this Agreement that You leave inside the Property or that is attached to the Property. Wewill try to return that property to You or make it available for You to claim.After We have possession of the Property, We can sell it and apply the money to any amounts You owe Us. We will give Younotice of any public disposition or the date after which a private disposition will be held. Our expenses for taking possession ofand selling the Property will be deducted from the money received from the sale. Those costs may include the cost of storing theProperty, preparing it for sale and attorney's fees to the extent permitted under state law or awarded under the Bankruptcy Code.If You have agreed to pay the Loan, You must pay any amount that remains unpaid after the sale money has been applied to theunpaid balance of the Loan and to what You owe under this Agreement. You agree to pay interest on that amount at the samerate as the Loan until that amount has been paid.10. DELAY IN ENFORCING RIGHTS AND CHANGES IN THE LOAN - We can delay enforcing any of Our rights under thisAgreement any number of times without losing the ability to exercise Our rights later. We can enforce this Agreement againstYour heirs or legal representatives. If We change the terms of the Loan, You agree that this Agreement will remain in effect.11. CONTINUED EFFECTIVENESS - If any part of this Agreement is determined by a court to be unenforceable, the rest willremain in effect.12. NOTICE FOR ARIZONA OWNERS OF PROPERTY - It is unlawful for You to fail to return a motor vehicle that is subject to asecurity interest, within thirty days after You have received notice of default. The notice will be mailed to the address You gaveUs. It is Your responsibility to notify Us if Your address changes. The maximum penalty for unlawful failure to return a motorvehicle is one year in prison and/or a fine of $150,000.00.

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Credit Union Acct No. Loan No.

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The following notice applies ONLY when the box at left is marked.13. NOTICE: ANY HOLDER OF THIS CONSUMER CREDIT CONTRACT IS SUBJECT TO ALL CLAIMS ANDDEFENSES WHICH THE DEBTOR COULD ASSERT AGAINST THE SELLER OF GOODS OR SERVICESOBTAINED PURSUANT HERETO OR WITH THE PROCEEDS HEREOF. RECOVERY HEREUNDER BY THEDEBTOR SHALL NOT EXCEED AMOUNTS PAID BY THE DEBTOR HEREUNDER.14. OTHER PROVISIONS -

SIGNATURESBy signing, or otherwise authenticating, as Borrower, You agree to the terms of the Loan Agreement. If Property is described inthe "Security" section of the Truth in Lending Disclosure, You also agree to the terms of the Security Agreement. If You sign, orotherwise authenticate, as "Owner of Property" You agree only to the terms of the Security Agreement.

CAUTION: IT IS IMPORTANT THAT YOU THOROUGHLY READ THE AGREEMENT BEFORE YOU SIGN ITBorrower 1 Signature Date

X (Seal)

Borrower 2 Signature Date

X (Seal)

Signature Date

X (Seal)

Signature Date

X (Seal)Borrower 3: Borrower 4:Owner of Property Witness Owner of Property Witness

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CUNA Mutual Group 1993, 94, 2003, 05, 06, 08 All Rights Reserved 01201196-D1200-C-1-042817 (D12004)-eCREDIT UNION COPY

Work Phone:Home Phone: Payroll No:

Credit Union R/T No:

SSN/TIN:

$Share Draft/Checking

By signing below or otherwise authenticating, I authorize my employer to deduct from my salary the amounts indicated on thisAuthorization and to deposit these funds at the Credit Union for each payroll period following receipt of this Authorization untilfurther notice from me. I understand that this Authorization is revocable. If this is a change in a previous Authorization, I instructmy employer to cancel my previous Authorization and to follow this Authorization. I grant the Credit Union a power of attorneyto increase or decrease the amount of my deduction upon my written or verbal request. This power of attorney only applies to aloan or credit extension for which the payment may vary. I authorize my employer to honor any payment change made under thispower of attorney.

#

$

By signing above or otherwise authenticating, I authorize the Credit Union to apply my payroll deduction for each pay period asfollows:

Share/Savings

Payroll Deduction/Direct Deposit Start Date:

Savings

Member:

Deposit To:

PAYROLL DEDUCTIONDIRECT DEPOSITAUTHORIZATION

Deposit Amount:

Employer:

Checking

#

$Net Check

CREDIT UNION DIRECT DEPOSIT AUTHORIZATION

Signature

EMPLOYER PAYROLL DEDUCTION AUTHORIZATION

X

$Money Market #

$Loan #

$Loan #

$IRA #

$Other: #

$Other: #

$TOTAL

WeeklyPayroll Period: Monthly

Biweekly Semi-Monthly

Date

MEMBER NO:

Initial Authorization Change in Authorization

Account No: Group No:

Strike Loan 50.00

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