* Indicates Required

• Application Requirements

  Eligibility

  Please select your eligibility *

  I live or work in Appanoose County, Davis County, Jefferson County, Keokuk County, Mahaska County, Van Buren County, or Wapello County. I am an immediate family member of a current Meridian CU member.

  Whether you are eligible is required

  How did you hear about us? *

  Friend/Family Internet TV Social Media Other Other:

  How you heard about us is required

  Application Type

  Ownership Type *

  Individual Account Joint Account

  Ownership Type is required

  Account Type *

  Primary Share Savings Youth Savings

  Account Type is required
• Step 2

  Tell us about you

  Your Name

  First Name *

  Middle Initial

  Last Name *

  Where do you live?

  Address *

  Address Line 2

  City *

  State *

  Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming

  Zip *

  Contact Information

  Primary Phone *

  Work Phone *

  Email *

  You must provide a valid email address to complete your application. We ask for your email address so we can send you important communications relating to your application. Please see our Privacy Policy for more details.

  How would you prefer we contact you? *

  Primary Phone Work Phone Email

  Preferred Contact Method is required
• Step 3

  Identifying Information

  We need this information to verify your identity. Information passed through this form is secure.

  Date of Birth *

  Social Security Number *

  Government Issued Photo ID *

  Driver's License Passport State-Issued ID Card U.S. Government ID

  ID Number *

  Drivers License State

  Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming

  Issue Date *

  Expiration Date *
• Step 4

  Joint Applicant Information

  We also need information about your Joint Applicant! The next few pages (with "Joint Applicant Information" at the top) ask questions about your Joint Applicant.

  Tell us about you

  Your Name

  First Name *

  Middle Initial

  Last Name *

  Where do you live?

  Address *

  Address Line 2

  City *

  State *

  Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming

  Zip *

  Contact Information

  Primary Phone *

  Work Phone *

  Email *

  You must provide a valid email address to complete your application. We ask for your email address so we can send you important communications relating to your application. Please see our Privacy Policy for more details.

  How would you prefer we contact you? *

  Primary Phone Work Phone Email

  Preferred Contact Method is required
• Step 5

  Joint Applicant Information

  Identifying Information

  We need this information to verify your identity. Information passed through this form is secure.

  Date of Birth *

  Social Security Number *

  Government Issued Photo ID *

  Driver's License Passport State-Issued ID Card U.S. Government ID

  ID Number *

  Drivers License State

  Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming

  Issue Date *

  Expiration Date *

• TIN certification and backup withholding information

  Under penalties of perjury, I certify that:

  The number shown on this form is my correct taxpayer identification number (or I am waiting for a number to be issued), and
  I am not subject to backup withholding because: (a) I am exempt from backup withholding, or (b) I have not been notified by the Internal Revenue Service (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, and
  I am a U.S. citizen or other U.S. person. For federal tax purposes, you are considered a U.S. person if you are: an individual who is a U.S. citizen or U.S. resident alien; a partnership, corporation, company, or association created or organized in the United States or under the laws of the United States; an estate (other than a foreign estate); or a domestic trust (as defined in Regulations Section 301.77701.7).
  The FATCA code(s) entered on this form (if any) indicating that I am exempt from FATCA reporting is correct.

  Certification Instructions.Complete a W-8 BEN if you are not a U.S. person. If a W-8 BEN is completed, your signature does not serve to certify this section.

  Primary Applicant Date *

  Joint Applicant Date *