Kenmore Teachers FCU

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VISA Debit Card Instant Issue Application Form

If you have an electronic copy of your pay stub, you can upload it as part of your application. If not, you can email it to us at newloans@kenteachfcu.com after you submit this form. Please note, we cannot review your application until we have received a recent copy of your pay stub.
Applicant Information
Applicant Full Name*

First NameMiddle InitialLast NameSuffix
Applicant Mobile Phone*
Please enter a valid phone number.
Applicant Email*
example@example.com
Applicant Date Of Birth*

MonthDayYear
Date
Applicant SSN*
Applicant Home Phone
Please enter a valid phone number.
Account Information
Enter the Share Draft/Checking Account for this Debit Card.*
Account Ownership*

JointIndividual
Account Type*

Share/Savings with Share Draft/CheckingShare/Savings Only
Select how you want your Debit Card Issued to you.*

Yes, Instant Issue CardYes, Mail Card to Me
How many cards do you want issued?*
Enter Number of Debit Cards.
Debit Card Holder #1*

First NameLast NameSuffix
Debit Card Holder #2

First NameLast NameSuffix
Debit Card Holder #3

First NameLast NameSuffix
Debit Card Holder #4

First NameLast NameSuffix
Debit Card Courtesy Pay Opt/In*

YesNo
By clicking "Yes" above, you agree to the terms and conditions associated with Debit Card Courtesy Pay.

Note, Debit Card Courtesy Pay provides a $50 overdraft line-of-credit. If you desire to increase your overdraft line-of-credit, you need to indicate the amount and provide a recent pay stub.

It is very important that you understand the fee details of Debit Card Courtesy Pay. For more information on the mechanics and fee structure of Debit Card Courtesy Pay, CLICK HERE.
Do you want to increase your Debit Card Courtesy Pay?*

YesNo
Line-of-Credit Increase Amount*
The maximum amount of credit limit increase is $500.
Co-Applicant Information
Co-Applicant Applicant Name*

First NameMiddle InitialLast NameSuffix
Co-Applicant Cell Phone*
Please enter a valid phone number.
Co-Applicant Email*
example@example.com
Applicant Employer Information
Employment Status*
If Employment Other, please explain.*
Enter your gross monthly pay:*
Employer Name*
Employer Phone*
Please enter a valid phone number.
Employer Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Upload Your Pay Stub

If you have an electronic copy of your pay stub, you can upload it as part of your application. If not, you can email it to us at newloans@kenteachfcu.com after you submit this form. Please note, we cannot review your application until we have received a recent copy of your pay stub.
Upload Your Pay Stub

Cancelof
Review & Submit
Application Terms & Conditions
By signing or otherwise authenticating below: 1. You promise that everything you have stated in this application is correct to the best of your knowledge, and that the above information is a complete listing of what you owe. If there are any important changes you will notify us in writing immediately. You authorize the Credit Union to obtain credit reports in connection with this application for credit and for any update, increase, renewal, extension, or collection of the credit received. You understand that the Credit Union will rely on the information in this application and your credit report to make its decision. If you request, the Credit Union will tell you the name and address of any credit bureau from which it received a credit report on you. It is a crime to willfully and deliberately provide incomplete or incorrect information in this application. 2. If you are applying for a credit card, you understand that the use of your card will constitute acknowledgment of receipt and agreement to the terms of the Consumer Credit Card Agreement and Disclosure.
Confirm Application Terms & Conditions*

I have read and agree to the above application Terms & Conditions
Please Acknowledge the Need to Submit Proof of Income*

I understand that I must submit a copy of my proof of income prior to this application being reviewed.
eSignature*

You acknowledge that by clicking the SUBMIT button you are giving your Signature approval to this Application
I am not a Robot.*
Should be Empty:

Let's Get Started

VISA Debit Card Instant Issue Application Form

Applicant Information

Account Information

Co-Applicant Information

Applicant Employer Information

Upload Your Pay Stub

Review & Submit

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