Accounts Opening Form and Agreement

Thank you for your interest in joining the MassMutual Federal Credit Union.

Membership in the Credit Union is currently open to employees of the MassMutual Financial Group and their
immediate family members.

* indicates a required field

I would like to open the following accounts:
Savings (required)	Checking	Vacation Club	Share Certificate
Money Market Plus	High Yield Checking	Holiday Club
I would like to add or apply for the following additional services:
CUOnline Home Banking	Online Bill Payment	Online Statement
ATM/Visa Check Card	Platinum Visa Credit Card	Overdraft Line of Credit

1. Primary Member

*Name (First M. Last)
*Social Security/Taxpayer ID#
*Drivers License or Other ID Number
*Drivers License or Other ID State
*How Eligible to Join Credit Union:	Employer Family Member of Retiree'
*Birth Date - Month/Day/Year	/ /
*Place of Birth - City/State	,
*Home Address - Street
*City, State, Zip	,
*How Long at Address?
*Mother's Maiden Name
Mailing Address (if different)
*E-mail WORK	check if preferred
E-mail HOME	check if preferred
*Home Phone
*Work Phone
Cell Phone

Name (First M. Last)
Social Security/Taxpayer ID#
Drivers License or Other ID Number
Drivers License or Other ID State
Birth Date	/ /
Place of Birth - City/State	,
Home Address - Street
City, State, Zip	,
How Long at Address?
Mother's Maiden Name
E-mail WORK	check if preferred
E-mail HOME	check if preferred
Home Phone
Work Phone
Cell Phone

MMFCU Privacy Policy	Fee Schedule	Certificate Disclosure
Account Information (Including Funds Availability, Terms & Conditions, Electronic Transfers, Truth In Savings)

*Please Check This Box To Indicate That All Listed Owners Have Read And Accept The Above Terms & Conditions And Other Disclosures

* indicates a required field