Membership Application

1Primary Applicant > 2Joint Applicant > 3Beneficiaries > 4Review Your Entry
Membership Qualification (Example: Live in Montrose)
Name and Relation of Family Member
USA Patriot Act

Member Identification Requirements

In accordance with Section 326 of the USA Patriot Act, applicants for new accounts are requested to provide current picture identification that verifies identity including name, address and other identifying information.

In some cases, identification will be requested for current members if original documentation was not obtained with the opening of the account. In all cases, protection of our members’ identity and confidentiality is our pledge to you.

We proudly support all efforts to protect and maintain the security or our members and our country.
Member Number (if applicable)
I/We authorize NuVista Federal Credit Union to open the following accounts:

I/We authorize NuVista Federal Credit Union to open the following accounts: Share (Savings) - Required Certificate of Deposit Checking IRA Share Money Market Youth Account
Individual or Joint Account

Individual or Joint Account Individual Joint
Primary Applicant Information Primary Applicant Information First Middle Last
SSN
Must be 9 digits. Currently Entered: 0 digits.
Input numbers only with no dashes or spaces.
Date of Birth (mm/dd/yyyy) Date of Birth (mm/dd/yyyy) / MM / DD YYYY
Physical Address Physical Address
Street Address City State Zip Code Country
Mailing Address (if different than physical address) Mailing Address (if different than physical address)
Street Address or PO Box City State Zip Code Country
Email Address
Phone Phone - ### - ### ####
Home Phone Home Phone - ### - ### ####
Work Phone Work Phone - ### - ### ####
Upload 2 Forms of Photo ID
- State Drivers License - State ID - US Military ID - US Passport

Attach Files
Upload 2nd Form of ID
- Social Security Card - US Passport - etc.

Attach Files
Primary Applicant Employment Information
Employed by
Employer Address
Occupation
Save my progress and resume later
Enter Your Email Address *

A special link to resume the form will be sent to your email address.

Membership Application

Membership Application

USA Patriot Act

Primary Applicant Employment Information