BUSINESS ACCOUNT APPLICATION
Thank you for applying for NASA Federal Credit Union’s business account services. To expedite the processing
of your application, please note the following requirements:
•
Businesses, other than sole proprietorships, will need to become Sponsor Employee Groups (SEGs)
before completing the Business Account Application. As a SEG, the business’ employees and family
members are eligible to take advantage of all NASA Federal Credit Union services. To produce your
request to become a SEG, go to http://www.nasafcu.com/ambassador/joincompany.asp, fill out the form,
print the letter on company letterhead and provide an authorized signature.
•
The par value of one share in this Credit Union is $5.00 and must remain on deposit at all times.
•
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 and
entity that opens an account. In addition to a completed application, NASA Federal Credit Union will ask
to see one non-expired government issued picture identification (ID) for all parties named on the
account. Acceptable picture Ids include a driver's license, state issued ID card, passport with attached
INS paperwork (with an expiration date of more than 90 days), Resident Alien Card or military ID. We
may also require secondary ID and other identifying documentation.
•
Any owners or authorized signers not present at the time of application must submit a notarized copy of
one of the aforementioned picture IDs.
•
A deposit sufficient to cover the minimum opening balance for the account(s) selected is required.
Please make checks payable to the business.
All businesses will be required to provide the Credit Union with the following documents:
•
Tax Identification Certification form(if the business is using an EIN)
•
60 days of previous financial institution statements for the business (personal statements may be
requested for new businesses)
•
Authorization for use of facsimile signature (when applicable; use form FS 101 available at the Credit
Union)
•
Business Certification if the business is established in a state other than MD, VA, or DC.
Sole Proprietorship
•
State and/or County Registration documents
•
Certificate of Assumed Name (if applicable)
Partnership
•
Certificate of Assumed Name
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Partnership Authorization Certification
Limited Liability Company
•
Articles of Organization
•
Certificate of Existence (letter issued by the state)
•
Operating Agreement
Corporation/Association/Organization
•
Articles of Incorporation
•
Corporate Charter/Certificate of Existence (letter issued by the state)
Account Number
APPLICATION FOR BUSINESS
SERVICES
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New Account□
Account Update□
Business Savings$50 opening balance required
□
Business Checking*$100 opening balance required
□
Business Checking With Interest*$100 opening balance required
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Business Check Card** * Requires approval** Requires an additional application and approval.
□
Business Premier Money Market Account$10,000 opening balance required
□
Business Premier Plus Money Market Account$40,000 opening balance required
□
Business Certificate$1,000 opening balance per certificate required. Term:
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6 months□
2 years□
4 years□
1 year□
3 years□
5 years□
Other (please specify): _________________________ _______________________________________________PLEASE TELL US ABOUT YOUR BUSINESS
Business Name
Street Address (No P.O. Box) Mailing Address (if different from street address)
City/State/Zip City/State/Zip
Business Phone Number ( )
Business Fax Number ( ) Business E-Mail Address Business Website
SIC / NAICS Code Type of Business (i.e.: Restaurant) Tax I.D. Number/Social Security Number Number Of Employees
State of Organization Date Established Present Mgmt Since (Year) Legal Status
□
Sole Proprietorship□
Corporation (Subchapter S or C)□
Limited Liability Company□
General Partnership□
Limited Partnership□
Non-Profit□
Other: _____________________________________PLEASE INDICATE AUTHORIZED SIGNERS
Name of Authorized Signer 1 Name of Authorized Signer 2
Title Title Address Address City/State/Zip City/State/Zip Home Phone ( ) Work Phone ( ) Home Phone ( ) Work Phone ( ) Social Security Number Date of Birth Social Security Number Date Of Birth
PLEASE INDICATE AUTHORIZED SIGNERS
Name of Authorized Signer 3 Name of Authorized Signer 4
Title Title
Address Address
City/State/Zip City/State/Zip
Home Phone
( ) Work Phone ( ) Home Phone ( ) Work Phone ( )
Social Security Number Date of Birth Social Security Number Date Of Birth
Driver’s License Number State Driver’s License Number State
SOLE PROPRIETORSHIP: You are doing business as (trade name) __________________________________________ and certify that you are the sole owner of the business entity.
Signature Date Print Name Title
PARTNERSHIP: You are doing business as (trade name) ________________________________________________ and certify authority for transactions on this account to any of _______ (number) of the individuals named here*:
Partner 1 Signature Date Partner 3 Signature Date
Print Name Title Print Name Title
Partner 2 Signature Date Partner 4 Signature Date
Print Name Title Print Name Title
CORPORATION / LIMITED LIABILITY COMPANY / ASSOCIATION / ORGANIZATION: The undersigned Secretary or Managing Member (“Secretary”) of _______________________________________________ (“business”), hereby certify that this is a true copy of the resolution adopted by the
accordance with its charter, by-laws and applicable laws was held on the ________ day of __________20____. The Board of Directors of the business, duly called and held in Secretary further certifies that a quorum was present and voting throughout, by unanimous written consent of the Board of Directors and that said Resolution has not been altered, amended or rescinded and is now in full force and effect; RESOLVED THAT:
1. Each person named on this account*, or any ____ (number) of them are hereby authorized in the name and on behalf of this business to deposit, withdraw, and/or transfer funds on deposit from the Credit Union (unless otherwise specified). 2. Any action heretofore taken by any officer of this business with respect to any of the matters stated above is hereby ratified and confirmed.
3. The Secretary is to be responsible for collecting or destroying all access devices used by previous authorized signers and changing all PINs or access codes to the account.
4. These Resolutions, insofar as said Credit Union is concerned, shall continue in full force and effect until said Credit Union receives written notice from the Secretary of the changes, if any therein.
I hereby further certify that the above Resolution does not conflict with the provisions of the business’ charter or its by-laws, and that the present holders of the offices referred to in the foregoing Resolutions and their specimen signatures are set forth below.
* Fees may apply for signature verification if you require more than one signature.
CORPORATION / LIMITED LIABILITY COMPANY / ASSOCIATION / ORGANIZATION:
Secretary or Managing Member Signature Date
Principle 1 Signature Date Principle 3 Signature Date
Print Name Title Print Name Title
Principle 2 Signature Date Principle 4 Signature Date
Print Name Title Print Name Title
TAXPAYER ID NUMBER (TIN) CERTIFICATION AND BACKUP WITHHOLDING
Under penalties of perjury, you certify that:
1. The number shown on this form is your correct taxpayer identification number (TIN).
2. You are not subject to backup withholding because (a) you are exempt from backup withholding, or (b) you have not been notified by the Internal Revenue Service that you are subject to backup withholding as a result of failure to report all interest or dividends, or (c) the IRS has notified you that you are no longer subject to backup withholding.
3. You are a U.S. person (including a U.S. resident alien).
Certification Instructions – You must cross out item 2 above if you have been notified by the IRS that you are currently subject to backup withholding.
SIGNATURES
(Owners, partners, and authorized signers are required to sign below)
Required Signers: CORPORATION: The person(s) named in the Corporate Resolution. PARTNERSHIP: All partners. SOLE PROPRIETORSHIP: The owner. LIMITED LIABILITY COMPANY: All trustees.
By signing below, you authorize NASA Federal Credit Union to open the type of depository account and/or service designated herein and warrant the truth of the information contained herein and in subsequent representations to US. You realize that such information will be relied upon by the Credit Union in determining Your membership eligibility and that certain other sources will also be used to verify such eligibility. You authorize NASA Federal Credit Union, Our employees and agents to investigate and verify any information provided to Us by You and to obtain Your credit report from applicable credit reporting agencies now or at anytime in the future and You further authorize any person, association, firm, corporation, or personnel office to furnish information concerning Your affairs upon Our request, including, but not limited to, providing credit and financial history information as well as that information We deem necessary to comply with the USA PATRIOT Act. You acknowledge that You have received a copy of the Business Account Agreement and the related disclosures as described in such Agreement, that You have read it and that You agree to and accept the terms and conditions found therein. In addition to establishing the Account designated herein, You may also from time to time request additional Accounts and/or Account Services be established on Your behalf and/or the addition and/or deletion of authorized signer(s) of Your Account(s). Your signature below is your continuing authorization for NASA Federal Credit Union to follow Your written or verbal instructions to do so and You agree that your continuing authorization will remain in effect unless We receive written instructions to the contrary. You hereby authorize Us to recognize any of the signatures subscribed herein in the payment of funds or the transaction of any business for Your Account(s)
THE INTERNAL REVENUE SERVICE DOES NOT REQUIRE YOUR CONSENT TO ANY PROVISION OF THIS DOCUMENT OTHER THAN THE CERTIFICATION REQUIRED TO AVOID BACKUP WITHHOLDING.
Signature 1 Date Signature 2 Date
Print Name Title Print Name Title
Signature 3 Date Signature 4 Date
Print Name Title Print Name Title
Signature 5 Date Signature 6 Date
Print Name Title Print Name Title
Signature 7 Date Signature 8 Date
Print Name Title Print Name Title
CREDIT UNION USE ONLY
Account Number Teller ID Reference No. Branch/Office Date Opened
Membership (Business) Officer Signature Date Agreements And Disclosure and Account Fees were given / sent (circle one) on
(date):____________________
ChexSystems (Business)
TIN/EIN Issued State No. Records Date of Records
Institutions ID/Documents Verified Comments
ChexSystems (Owner)
TIN/EIN Issued State No. Records Date of Records
Institutions ID/Documents Verified Comments
ChexSystems (Owner / Authorized Signer)
TIN/EIN Issued State No. Records Date of Records
Institutions ID/Documents Verified Comments
ChexSystems (Owner / Authorized Signer)
TIN/EIN Issued State No. Records Date of Records
