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USA PATRIOT Act Notice

IMPORTANT INFORMATION ABOUT PROCEDURES FOR OPENING A NEW ACCOUNT

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 who opens an account.

What this means for you: When you open an account, we will ask for your name, address, date of birth and other information that will allow us to identify you. We may also ask to see your driver’s license or other identifying documents.

  • Loan Application

  • Phone 860-291-0345
    Fax 860-282-5819
    Email: loans@afncu.com
  • There are costs associated with the use of a credit card. Information about costs, rates, and fees may be contained in disclosures provided with this application or by calling us toll-free at 860-291-0345 or writing to us at the address stated on this application.
  • INDIVIDUAL CREDIT: Complete Applicant section. Complete Co-Applicant, Spouse, (referred to as "Other") section: (1) about your spouse if you live in a community property state (AZ, CA, ID, LA, NM, NV, TX, WA, WI), or (2) if your spouse will use the Account. Please check box to indicate whom the information is about.
  • JOINT CREDIT: Each Applicant must individually complete the appropriate section below. If Co-Applicant is spouse of the Applicant, mark the Co-Applicant box.

  • APPLICANT INFORMATION

  • Applicant

  • EMPLOYMENT INFORMATION

  • INCOME INFORMATION

  • NOTICE: Alimony, child support, or separate maintenance income need not be revealed if you do not choose to have it considered.

  • References

    (Please include Street, City, State and Zip)

  • OTHER

  • EMPLOYMENT INFORMATION

  • INCOME INFORMATION

  • NOTICE: Alimony, child support, or separate maintenance income need not be revealed if you do not choose to have it considered.

  • REFERENCES

    (Please include Street, City, State and Zip)

  • ASSETS - WHAT YOU OWN

    List all assets.

  • Applicant Information

  • Other Information (Co-Applicant, Spouse)

  • DEBTS - WHAT YOU OWE

    In addition to Rent/Mortgage list all other debts (for example, auto loans, credit cards, second mortgage, home assoc. dues, alimony, child support, child care, medical, utilities, auto insurance, IRS liabilities, etc.) Please use a separate line for each credit card and auto loan. Attach other sheets if necessary.

  • Applicant Information

  • Other Information (Co-Applicant, Spouse)

  • OTHER INFORMATION

  • Applicant

  • Other (Co-Applicant, Spouse)

  • ADDITIONAL INFORMATION

  • STATE LAW NOTICES

  • Notice to Nebraska Residents: A credit agreement must be in writing to be enforceable under Nebraska law. To protect you and us from any misunderstandings or disappointments, any contract, promise, undertaking, or offer to forear repayment of money or to make any other financial accomodation in connection with this loan of money or grant or extention of credit, or any amendment of, cancellation of, waiver of, or substitution for any or all of the terms or provisions of any instrument or document executed in connection with this loan of money or grant or extension of credit, must be in writing to be effective.
    Notice to New York Residents: New York residents may contact the New York State Department of Financial Services to obtain a comparative listing of credit card rates, fees, and grace periods, New York State Department of Financial Services: 800-342-3736 or www.dfs.ny.gov
    Notice to Ohio Residents: The Ohio laws against discrimination require that all creditors make credit equally available to all creditworthy customers, and that credit reporting agencies maintain separate credit histories on each individual upon request. The Ohio Civil Rights Commission administers compliance with this law.
    Notice to Wisconsin Residents: (1) No provision of any marital property agreement, unilateral statement under Section 766.59, or court decree under Section 766.70 will adversely affect the rights of the Credit Union unless the Credit Union is furnished a copy of the agreement, statement or decree, or has actual knowledge of its terms, before the credit is granted or the account is opened. (2) Please sign if you are not applying for this account or loan with your spouse. The credit being applied for, if granted, will be incurred in the interest of the marriage or family of the undersigned.

  • CONSENSUAL SECURITY INTEREST

  • You grant us a security interest in all individual and joint share and/or deposit accounts you have with us now and in the future to secure your credit card account. Shares and deposits in an IRA or any other account that would lose special tax treatment under state or federal law if given as security are not subject to the security interest you have given in your shares or deposits. You may withdraw these other shares unless you are in default. When you are in default, you authorize us to apply the balance in these accounts to any amounts due. For example, if you have an unpaid credit card balance, you agree we may use funds in your account(s) to pay any or all of the unpaid balance.

    By signing or otherwise authenticating below, you are affirmatively agreeing that you are aware that granting a security interest is a condition for the credit card and you intend to grant a security interest.

  • SIGNATURES

  • By signing or otherwise authenticating below:
    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 all your debts and obligations. 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. You understand that it is a crime to willfully and deliberately provide incomplete or incorrect information in this application. If there are any important changes, you will notify us in writing immediately. You also agree to notify us of any change in your name, address or employment within a reasonable time thereafter.
    You authorize the credit union to obtain credit reports in connection with this application for credit and for any update, renewal or extension of the credit received and for other accounts, products, or services we may offer you or for which you may qualify.
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