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Membership Application

Important Information About Procedures for Opening a New Account

Note: The information you enter is housed on a secure site and will be handled in a confidential manner.

It's so easy to join SSSCU! Please provide all the information requested on the membership application that follows, or call our Contact Center at 702.733.8820. We will process your application and mail a signature card to you. You can then visit the branch of your choice to sign the card, deposit $100 membership fee required, and show proof of valid ID. Click here for a list of SSSCU branches and addresses.

Bold field denotes required field.

If you are unable to visit an SSSCU branch, you may have your signature on the card notarized by a Notary Public, and returned with a photocopy of the valid ID.

Before you complete the application, please select at least one eligibility requirement for membership:

I work in, or am a volunteer, trustee or board member of a public or private school, college, university, school district or educational association located in the state of Nevada.

I am aged 18 or older, and I am enrolled as a student in a public or private school, college or university.

I am a retiree, pensioner, or annuitant of a public or private school, college, university, school district or educational association.

I am an employee or retiree of this credit union or one of its affiliates.

I am aged 18 or older and a sponsor of Vegas PBS, Las Vegas' PBS Television Station.

I am employed by one of the following Southern Nevada companies (choose one):

I am a member of one of the following stakes of the Church of Jesus Christ of Latter Day Saints in the State of Nevada; Lakes, Las Vegas, Lone Mountain, Meadows, Redrock, Sandstone, or South.

I am a spouse of a person who died while within the field of membership of this credit union, or a spouse of a person retired as a pensioner or annuitant from one of the above employers, or a member of their immediate family.

I am a family member of an eligible member of this credit union.

Family Member Name
Relationship


Type of Ownership
Account to Open Hold CTRL for multiple selections
Services You Want Hold CTRL for multiple selections

Primary Account Holder
Social Security Number	ex. 123456789
Last Name
First Name
Middle Name
Date of Birth	ex. mm/dd/yyyy
Rent/Own
Street Address
City
State
Zip Code
Home Phone	ex. 123-456-7890
Drivers License#
Drivers License State
Mothers Maiden Name
Employer Name
Monthly Income	$
Work Phone	Extension
E-Mail Address

Joint Account Holder
	Address same as Primary
Social Security Number
Last Name
First Name
Middle Name
Date of Birth
Rent/Own
Street Address
City
State
Zip Code
Home Phone
Drivers License#
Drivers License State
Mothers Maiden Name
Employer Name
Monthly Income	$
Work Phone	Extension
E-Mail Address

Tin Certification and 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 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: Cross out item 2 above if you have been notified by the IRS that you are currently subject 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.

Authorization

By submitting this application to the credit union, you certify that everything you have stated in this application is correct to the best of your knowledge. You understand that the credit union will rely on the representations you make in this application when deciding whether to grant membership. You agree to immediately notify us of changes to any of the information you have provided in this application. You understand that it is a federal crime to willfully and deliberately provide incomplete or incorrect information on applications made to Credit Unions or State Chartered Credit Unions. You authorize the credit union to submit your information to ChexSystems in order to verify your personal financial standing, and to obtain credit reports in connection with this application for credit and for any update renewal or extension of the credit received. If you request, the credit union will provide you with the name and address of any credit bureau from which it received your credit report. You will be required to provide us with a valid picture ID (Drivers license or Passport). By submitting this application you also agree to the terms of the agreements set out below, applicable to the accounts and services requested, which will be sent to you upon opening your membership account.

Membership and Account Agreement. You acknowledge receipt of and agree to the terms and conditions of the Membership and Account Agreement, Truth-in-Savings Rate and Fee Schedule, Funds Available Policy Disclosure, if applicable, and to any amendment the Credit Union makes from time to time which are incorporated herein.
Overdraft Loan Agreement. If an Overdraft Loan Account is requested and provided, you acknowledge receipt of and agree to the terms of the Overdraft Loan Agreement and Truth in Lending Disclosure.
Electronic Funds Transfer Agreement. If an access card or Electronic Funds Transfer (EFT) Service is requested and provided, you acknowledge receipt of and agree to the terms of the Electronic Funds Transfer Agreement.

The Internal Revenue Service does not require your consent to any provision of this Account Card other than the certifications required to avoid backup withholding.

American Share Insurance, by vote of the membership, deposits in Silver State Schools Credit Union are insured by American Share Insurance, a private deposit insurance provider up to $250,000 per account, and up to an additional $250,000 by ESI, Excess Share Insurance Corporation. This institution is not federally insured, and if this institution fails, the federal government does not guarantee that depositors will get back their money.

ChexSystems or similar qualification is required to obtain both a membership savings and checking account at SSSCU

Patriot Act Information

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. The identification of an applicant processed through our website must be verified by a Nevada Notary Public. In some instances we reserve the right to request any individual to produce identification documentation in person.

We thank you for your cooperation. In addition to ensuring the security of your funds, and our country, these procedures will also enable us to provide even greater safeguards of your personal information against possible fraud.

I AGREE

Equal Housing Lender. Your deposits are insured to $250,000 per account by American Share Insurance. Additional coverage up to $250,000 provided by Excess Share Insurance Corporation.

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PO Box 12037, Las Vegas, NV 89112-0037
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