New TopLine Members

A minimum initial deposit of $5 is required to open your basic share savings account and establish your TopLine membership. The $5 is not a membership fee, but a deposit. It is yours to withdraw should you ever decide to discontinue your credit union relationship.

Establish your TopLine membership by completing the application below.  Print your completed application and mail it, along with your initial deposit of at least $5 to:

TopLine Federal Credit Union
ATTN: New Accounts Department
9353 Jefferson Highway
Maple Grove, Minnesota 55369.

Note: This form is for new membership only. If you are already a TopLine member, please use our Add Services Request Form to sign up for additional services.

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 and account.
What this means to you:
When you open an account, we 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.
Primary Owner of Account
I am eligible for membership at TopLine Federal Credit Union because I live, work, worship, volunteer or attend school in Anoka, Carver, Dakota, Hennepin, Ramsey, Scott or Washington County, Minnesota.

I am eligible because an immediate family member (grandparent, parent, spouse, sibling, child, grandchild, roommate) lives, works, worships, volunteers or attends school in Anoka, Carver, Dakota, Hennepin, Ramsey, Scott or Washington County, Minnesota.

Name of Relative:

I am eligible because I am an immediate family member or roommate of a current TopLine Member.

Name of Relative:

Last Name:
First Name:
Middle Name:
 
Residence Address:
(not P.O. Box)
City:
State:
ZIP Code:
 
Mailing Address:
(if different)
City:
State:
ZIP Code:
 
Social Security Number:
Driver's License Number:
State:
 
Day Phone:*
*The number where you can be reached for questions.
Eve. Phone:
Date of Birth:
 
E-Mail Address:
 
I HAVE / HAVE NOT had an account closed by a financial institution without my consent within the previous 12 months.
I AM / AM NOT Subject to back-up withholding.
I HAVE / HAVE NOT ever been convicted of a criminal offense because of the use of a check or other similar item in the previous 24 months.
I AM / AM NOT a U.S. Citizen or resident alien.
 
Password for
Identification:
 
Joint Owner
Last Name:
First Name:
Middle Name:
 
Residence Address:
(not P.O. Box)
City:
State:
ZIP Code:
 
Mailing Address:
(if different)
City:
State:
ZIP Code:
 
Social Security Number:
Driver's License Number:
State:
 
Day Phone*:
*The number where you can be reached for questions.
Eve. Phone:
Date of Birth:
 
E-Mail Address:
 
I HAVE / HAVE NOT had an account closed by a financial institution without my consent within the previous 12 months.
I AM / AM NOT Subject to back-up withholding.
I HAVE / HAVE NOT ever been convicted of a criminal offense because of the use of a check or other similar item in the previous 24 months.
 
I/we have read and agree to the Account Agreement.
I/we have read and agree to the Privacy Policy.
Enclosed is my check for $ (at least $5) to establish my account.
 
Everything I/we have stated in this Application is true to the best of my/our knowledge. I/we understand that TopLine will retain this Application whether or not it is approved. I/we understand that 18 U.S. Code, Section 1014 makes it a federal crime to knowingly make false statements on this Application. TopLine is authorized to verify my/our employment, check my/our credit history, and to answer questions about credit experience with me/us. By making this Application, I/we agree to (1) the terms and conditions governing all TopLine accounts; (2) the terms of any agreements for specific services such as checking, savings, time deposits, and electronic banking and (3) the terms of TopLine's Fee and Information Schedule as amended from time to time. I/we also agree to all terms, whether posted in your premises, printed on deposit slips, contained in your Fee and Information Schedule, or enclosed with statements. I/we understand that any of the terms may be changed by TopLine from time to time. The Internal Revenue Services does not require your consent to any provision of this document other than the certifications required to avoid back up withholding.


                                                                                                                               
Member Signature                                                                                      Date

                                                                                                                               
Joint Owner Signature                                                                                 Date


A notorized signature is required on all mail applications.

Notary Information

Complete if required by your credit union:

I certify that the information provided above is my true and correct identity information.

Signed                                                                                                               
              Member/Owner                                                                         Date

State of                                                      , County of                                         

City, Town, Village of                                                                                        

This person named heron personally came before me and signed above on this, the            day of                               , 20          .

My commission expires on                               , 20          .

                                                                                                                               
Notary Signature                                                                                         Date

                                                                                                                               
Printed Name                                                                                              Date

Notary Seal

                        
                        
                        
                        
                        
                        
                        
                        


Taxpayer ID Number Certification & Backup Withholding Information:
The Internal Revenue Service does not require your consent to any provision of this section other than the certification required to avoid backup withholding. Under penalties of perjury, I certify that (1) the number shown on this form is my correct taxpayer identification number, (2) 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 (3) I am a U.S. person (including a U.S. resident alien).
Instructions:Complete a W-8 BEN if you are not a U.S. person. By signing below, I certify under penalties of perjury that the statement above is correct.

                                                                                                                                    
Primary Member's Signature                                                                           Date
 
    
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