Box
|[pic] |P.O. Box 3489 |Arizona: (480) 441-5900 |Toll Free: (800) 528-1441 |
| |Scottsdale, AZ 85271-3489 |Texas: (512) 996-4000 |Fax: (602) 629-2085 |
| | | | |
REVOCABLE TRUST ACCOUNT APPLICATION
|Date: | |Member #: | |
| | | | |
| | New | Amended | Converted |
Complete application. Indicate N/A in fields that are not applicable.
|TRUST INFORMATION |
|Name of Trust |Date of Trust |How did you hear about TruWest? |
| | | |
|Street Address (Cannot be a P.O. Box) |City / State / ZIP |
| | |
|Mailing Address (If different from street address) |City / State / ZIP |
| | |
|Name of Grantor | Same as Trustee |Name of Grantor | Same as Trustee |
| |Different from Trustee | |Different from Trustee |
| | | | |
|Tax ID/SSN | |
| | |
|ACCOUNTS | Checking Account #________ | Select Savings #________ | Christmas Club #________ |
| |Type: Simply Traditional Preferred | Money Market #________ | Other: ________________ #________ |
| | Investment Certificate(s) |TERMS / ACCT # |
|OVERDRAFT PROTECTION |
|Initial only ONE: |
|By signing below, I certify, in accordance with the Internal Revenue Service (IRS) W-9 instructions, provided by the Credit Union, and other penalties of perjury, |
|that: (1) I am a U.S. person (including a U.S. resident alien); (2) the Social Security Number (SSN) or taxpayer identification number (TIN) shown is my/the |
|correct identification number; AND |
| Trust TIN/SSN |(3) I am not subject to backup withholding because (a) I am exempt from backup withholding, OR (b) I have not been notified by the IRS |
| |that I am subject to backup withholding as a result of a failure to report all interest or dividends, OR (c) the IRS has notified me that|
| |I am no longer subject to backup withholding. |
|MEMBER MUST CHECK NUMBER (3) ABOVE IF THEY HAVE BEEN NOTIFIED BY THE IRS THAT BACKUP WITHHOLDING APPLIES BECAUSE OF FAILURE TO REPORT ALL INTEREST AND DIVIDENDS ON |
|A TAX RETURN(S). Member understands that the IRS does not require consent to any provisions of this document other than the certifications required to avoid backup |
|withholding. |
|AUTHORIZATION |
| |
|By signing below, the trustee(s) certifies that they are a trustee for the living trust named on this document and are authorized to establish accounts at this |
|Credit Union. Under the terms of the trust documents, any one trustee (including a successor trustee that has assumed the role of trustee) is authorized, without |
|limitation, to make any instruction or execute any transaction on an account owned by the trust as if the trustee owned the account personally. The trustee |
|certifies that the terms of the trust documents are not in conflict with any term contained in this document. |
| |
|I agree to the terms and conditions of the Membership and Account Agreement, any fee and rate sheet disclosure documents, and any other separate disclosure |
|documents or agreements (“Disclosure Documents’) given to me relating to other financial services I requested, and to any future amendments you make from time to |
|time which are incorporated herein. I acknowledge receipt of a copy of all Disclosure Documents applicable to the accounts and services requested, and |
|understand that specific deposit insurance, rate, fee, and other related information is contained within those documents. I authorize the Credit Union to verify |
|or obtain further information which the Credit Union may deem necessary concerning my credit standing. |
| ? | | | |
| | Trustee #1 Signature | |Date |
|? | | | |
| |Trustee #2 Signature | |Date |
|? | | | |
| | Trustee #3 Signature | |Date |
TruWest Credit Union is chartered under the laws of Arizona and governed by a board of directors directly elected by its members.
|[pic] | |REVOCABLE TRUST ACCOUNT APPLICATION |
|Member #: | |
|TRUSTEE / BENEFICIARY INFORMATION |
|TRUSTEE #1 |
|Primary Trustee's Name |Tax ID/SSN |Birth Date |
| | | |
|Street Address (Cannot be a P.O. Box) |City / State / ZIP |Home Phone Number |
| | | |
|Mother's Maiden Name (Password) |E-mail Address |Cell Phone or Other |
| | | |
|TRUSTEE #2 |
|Trustee's Name |Tax ID/SSN |Birth Date |
| | | |
|Street Address (Cannot be a P.O. Box) |City / State / ZIP |Home Phone Number |
| | | |
|Mother's Maiden Name (Password) |E-mail Address |Cell Phone or Other |
| | | |
|TRUSTEE #3 |
|Trustee's Name |Tax ID/SSN |Birth Date |
| | | |
|Street Address (Cannot be a P.O. Box) |City / State / ZIP |Home Phone Number |
| | | |
|Mother's Maiden Name (Password) |E-mail Address |Cell Phone or Other |
| | | |
|SUCCESSOR TRUSTEES |
|Successor Trustee Name |Successor Trustee Name |
| | |
|Successor Trustee Name |Successor Trustee Name |
| | |
|BENEFICIARIES |
|Beneficiary Name |Beneficiary Name |
| | |
|Beneficiary Name |Beneficiary Name |
| | |
|CREDIT UNION USE ONLY |
|ZIP Code: | |Compass Code: | |
|Relationship to Member: | |Date Opened: | |
|Approved by: | | | |
| |Membership Officer | |Date |
TRUSTEE #1 |Attach ChexSystems Report |Member Funds Level |DEBIT CARD |Date: | |Term | 2 Years | |Year: | |State: |ι | | 1 2 3 | Approved Declined |By: | | | Other:________ | |ID Type |Number |Exp. Date |ATM/Debit Card #1: | |Issued to: | | |1 | | | |ATM/Debit Card #2: | |Issued to: | | |2 | | | |ATM/Debit Card #3: | |Issued to: | | |Chk Acct/Money Mkt #: | |ODP / TC Input: | |ATM/Debit Card #4: | |Issued to: | | |TRUSTEE #2 |Attach ChexSystems Report |Member Funds Level |TRUSTEE #3 |Attach ChexSystems Report |Member Funds Level | |Year: | |State: |ι | | 1 2 3 |Year: | |State: |ι | | 1 2 3 | |ID Type |Number |Exp. Date |ID Type |Number |Exp. Date | |1 | | | |1 | | | | |2 | | | |2 | | | | |Comments: | |BR# | |Teller #: | | |[pic]
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