Enrollment Form

Community Financial Credit Union
Online Teller Enrollment Form

Complete this form and print. This form may not be returned online because your signature is required to obtain Online Teller account access.
Return this form to our office, by fax to (417) 862-7802, or by mail to Community Financial Credit Union (CFCU), Attn: Electronic Services, PO Box 1217, Springfield MO 65801-1217.
Your Online Teller account access will be available within 5 business days after CFCU receives your signed enrollment form. You will be notified by email when your account access has been activated.
Remember the initial access code you enter below, you will need that code to access your account.

Sign me up for Online Teller!

Member Name CFCU Account #

Email Address

Address City State ZIP

Home Phone # Work Phone # Check if new address or phone #

Initial Access Code Requested (4 - 20 characters. Access codes are case sensitive):
(Remember this initial access code. You will need it to access your account.You are strongly encouraged to change your access code during your first online session. Select "Change Preferences" to get to the "Change Access Code" screen.)

Authorization

By signing below, I am applying for Online Teller service, which includes internet account access. I agree that my use of Online Teller will be governed by CFCU's Account Agreements and Disclosures and by the Internet Account Access Agreement and Disclosures which I have read. I agree to be bound by said disclosures. I understand that my access code is activited for security purposes to authenticate electronic transfers, and that I am responsible for safeguarding my access code. I understand that in disclosing my access code to anyone, I am providing that person with the authority to perform all transaction relating to my account(s), until I revoke that authority by changing the access code.

Primary Member's Signature
Date

Cross Account Access Request Form

Members can access different member accounts, known as Cross Accounts, through Online Teller and MemberConnect. Based on account ownership, members can transfer funds from one account to another. Enabling of cross account acess via the audio response system and/or internet banking will be executed by member request and upon Credit Union approval. To provide protection against fraud and to prevent loss to the Credit Union, cross account access to multiple accounts will only be granted when account ownership on all applicable accounts is verified. If Online Teller access has not yet been established for any of the accounts you list below, the initial access code(s) will be the same as you requested above.

I would like to have the capability of transferring funds to/from the following account(s). I am an owner or joint owner on this/these accounts. I agree to accept responsibility for the confidential nature of the access code(s) used to complete these transactions. I understand that Community Financial Credit Union is not liable for any losses in my account due to making this service available to me. I understand that it is my responsibility to notify Community Financial Credit Union of any changes in the status of any of these accounts.

Account #

I accept responsibility for all transactions made by me or any joint owner to whom I entrust my access code. I have read and agree to be bound by the terms and conditions of Community Financial Credit Union's Internet Account Access Agreement and Disclosures. The signature of the primary member on each account listed above is required.
Signature	Date	Signature	Date
Signature	Date	Signature	Date