Thank you for your interest in joining Hamilton Horizons Federal Credit Union. 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. Photo Identification such as your Driver’s License and or Passport Social Security Card (REQUIREMENT) *Proof of residency such as your lease. (or Gas & Electric or Telephone Bill) *If your mailing address is a P.O. Box you must provide your physical address Secondary Identification such as work badge. (REQUIREMENT) Minor Accounts: Social Security Card and Birth Certificate All new accounts require a share deposit of $5.00.

Please have all required documentation notarized when applying for membership through mail. If you have any questions, please call us at (609) 631‐4300 or Toll Free at 1 (800) 449‐3221.

Thank you,

Hamilton Horizons Federal Credit Union Member Service Department

Phone: (609) 631‐4300

Fax: (609) 631‐9605

Email: [email protected]


Membership & Account Application

Individual __  Minor __

Primary Member information

Member Name _____________________________________

Member # _____________________________________

Social Security # _____________________________________

Driver’s Lic. # _____________________________________

Address _____________________________________

City  _____________________________________

State __________________________________

Zip _____________________________________

Home Phone _____________________________________

Date of Birth _____________________________________

Mother’s Maiden Name _____________________________________

E-mail _____________________________________

Employer _____________________________________

Work Phone _____________________________________

Employer Location _____________________________________

Eligibility _____________________________________


Designate the ownership of the accounts and responsibility for the services requested.

Individual ___ Joint Account with Survivorship ____ Minor Account with Custodian ____

Joint Member/Custodian Name _____________________________________

Social Security # _____________________________________

Driver’s Lic. # _____________________________________

Address _____________________________________

City _____________________________________

State _____________________________________

Zip _____________________________________

Date of Birth _____________________________________

Mother’s Maiden Name _____________________________________

Home Phone _____________________________________

Work Phone _____________________________________

E-mail _____________________________________


TIN Certification And Backup Withholding Information Under penalties if perjury, I certify that:

(1) The number shown on this form is my correct taxpayer identification number.

(2) I am not subject to a backup withholding because (a) I am exempt from backup holdings, 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

(3) I am a U.S. person (including a U.S. resident alien) Certification Instructions: Cross out item 2 above if you have been notified by the IRS that your are currently subjected to backup withholding because you have failed to report all interest and dividends on your tax return. Cross out item 3 and complete a W-8 BEN if you are not a U.S. person.


By signing below, I/we agree to the terms and conditions of the Membership and Account Agreement, TruthIn-Savings Rate and Fee Schedule, Funds Availability Policy Disclosure, if applicable, and to any amendment the Credit Union makes from time to time which are incorporated herein. I/We have received and read the Agreement and Disclosures applicable to the accounts and services requested herein. If an access card or EFT service is requested and provided, I/we agree to the terms of and acknowledge receipt of the Electronic Funds Transfer Agreement. The Internal Revenue Service does not require your consent to any provision of this document other than the certifications required to avoid backup withholding.


Primary Member Signature_____________________________________ Date ______________

Joint Member/Custodian Signature _____________________________________ Date ______________

Products and Services

All of the terms, conditions, form of account ownership, account selection and other information indicated on this card apply to all of the accounts listed below unless the credit union is notified in writing of a change.

Please check items applying for:

Savings ____

Money Market ____

Checking ____

Certificate of Deposit (CD) ____

Business Account ____

Visa Credit Card ____

Cha-Ching Teen Club ____

“Name Your Own” Club Account ____

$tart $mart Savings Club ____

Please check items applying for:

Personal Password __________________________

Payroll Deduction $ ____

Direct Deposit ____

ATM Card No. ____

VISA Check Card ____

Online Banking ____

Vehicle Loan ____

Personal Loan ____

Home Loan ____

hereby make application for membership in the credit union named below, and agree to conform to its bylaws and amendments thereof, copies of which have been made available to me, and to subscribe for at least one (1) share. By signing this card, you authorized the credit union to obtain credit reports in connection with this application for membership, services and/or credit, and for update, renewal or extension of the credit received, if applicable. If you request, the credit union will tell you the name and address of any bureau from which it received a credit report on you. The Internal Revenue Service does not require your consent to any provision of this document other than the certifications required to avoid backup withholding.


Primary Member Signature ________________________________ Date __________

Joint Member/Custodian Signature _______________________________ Date ___________



Hamilton Horizons Federal Credit Union is hereby authorized to recognize any of the signatures subscribed in the payment of funds or the transaction of any business for this account. The joint owners of this account hereby agree with each other and with said credit union that all sums now paid in on shares, or heretofore or hereafter paid in on shares by any or all of said joint owners to their credit as such joint owners with all accumulations thereon, are and shall be owned by them jointly, with right of survivorship and be subject to the withdrawal or receipt of any of them, and payment to any of them or the survivor or survivors shall be valid and discharge said credit union from any liability for such payment. The joint owners also agree to the terms and conditions of the account as established by the credit union from time to time. Any of all of said joint owners may pledge all or any part of the shares in this account as collateral security to a loan or loans from the credit union. The right or authority of the credit union under this agreement shall not be changed or terminated by said owners, or any of them except by written notice to said credit union which shall not affect transactions theretofore made.


I/We hereby authorize the Hamilton Horizons Federal Credit Union (the Credit Union) to establish this Checking Account for me/us. The Credit Union is authorized to pay checks signed by me (or by any of us) and to charge all such payments against the shares in this Account. It is further agreed that:

(a) Only share draft blanks and other methods approved by the Credit Union may be used to make withdrawals from this Account.

(b) The Credit Union is under no obligation to pay a check that exceeds the fully paid and collected share balance in this Account. However, if any of the undersigned writes a check that would exceed such balance and results in this Account being overdrawn, the Credit Union may, nevertheless, pay such checks and transfer shares to this Account in the amount of the resulting overdraft, plus a service charge, from any other regular share account from which any of the undersigned is then eligible to withdraw shares.

(c) The Credit Union may pay a check on whatever day it is presented for payment, not withstanding the date (or any limitation on the time of payment) appearing on the check.

(d) When paid, checks become the property of the Credit Union and will not be returned either with the periodic statement of this Account or otherwise.

(e) Except for negligence, the Credit Union is not liable for any action it takes regarding the payment or nonpayment of a check.

(f) Any objections respecting any item shown on a periodic statement of this Account is waived unless made in writing to the Credit Union before the end of 60 days after the statement is mailed.

(g) This Account is subject to the Credit Union’s right to require advance notice of withdrawal, as provided in its bylaws.

(h) This account is also subject to such other terms, conditions and service charges as the Credit Union may establish from time to time.

(i) If this agreement is signed by more than one person, the persons signing above shall be the joint owners of the Account which, in that event, shall be subject to all terms and conditions printed on this application.

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Hamilton Horizons Federal Credit Union offers access to TruStage Insurance Services.  For more information, please call 609-631-4300 or toll-free 800-449-3221.

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