Checking Account Application

This application is for current ACU Members only
Please complete the form below, print it, and sign. Once completed please fax the form along with a clear copy of your Drivers License to our Main Office at (815) 267-7701 or mail it to 1350 West Renwick Road, Romeoville, IL. 60446, ATTN: Member Services.

* indicates a required field

Type: (Choose One) Smart Dividend Advantage Fresh Start

Primary Member Information
*Account Number:
*Date of Birth (mm/dd/yyyy):
*Last Name, First Name, Middle Initial:
, , Jr.
*Social Security Number:
*Street Address:
*City, State Zip: ,
*Home Phone:
*Work Phone:
*Mother's Maiden Name:

Joint Owner(s) Information
Last Name, First Name, Middle Initial: , ,
Date of Birth (mm/dd/yyyy):
Joint Owners Social Security Number:
Mother's Maiden Name:

Check Order Information
NO, I do not wish to order checks at this time.
YES, I would like checks (complete information below)
      An initial deposit is required to cover the cost of your checks.
Information to appear on checks: (Please check all that apply)
Name Address Home Phone # Work Phone #
Other (Please Explain)
Check Style (choose one)
1 Box of 150 Standard Checks at $19.69
Designer Checks (an ACU representative will contact you)

Automated Services Agreement
Sign me up for the automated services indicated below:
      (Choose all that apply)

Direct Deposit (click here for further instructions)
Visa Check Card (Additional cards are only issued to Joint Owners of ACU savings and checking accounts. Please note, VISA Check Cards can only be ordered for home address delivery.)
Phone banking with Audio Response Teller (A.R.T.)
On-line banking
Bill Payment

Overdraft Protection
No, I do not wish to have overdraft protection on my checking account at this time.
YES, I want overdraft protection for the above listed checking account. Transfer funds from
      the account(s) indicated below in the order that I have indicated by 1, 2, 3.
Share Savings Account
Money Market Account
Line-of-Credit Loan
I understand that the credit union is under no obligation to pay checks, which exceed the balance in my checking account. I authorize ACU to transfer funds from the above indicated accounts provided funds are available, and deposit these same funds into my checking account. I also understand that the number of share transfers may not exceed six per month. Overdraft transfers and Line of Credit advances will be processed in increments of $50.00.

By the signature(s) below I certify that all information on the application is true and correct and understand that providing untrue information may lead to the revocation of card privileges. I/we agree to the terms and conditions as set forth in ACU's Truth-in-Savings, Funds Availability and Automated Service Disclosures and Agreements requested herein which have been provided to me upon submission of this request or with my/our card(s). 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. I understand that ACU retains the right to revoke any card(s) provided to me without notice.

Member Signature _____________________________________     Date __________
Joint Owner Signature __________________________________     Date __________

Appropriate disclosures will be mailed to you upon receipt of this application.


For Office Use Only
  CK     ART     ODP     HB     BP
  Joint Account   Date Opened __________
        Opened By _________________________
  Check Card   Date Ordered __________

* indicates a required field