Fillable Printable Debit Card Application Form - Michigan
Fillable Printable Debit Card Application Form - Michigan
Debit Card Application Form - Michigan
I would like to apply for a Michigan Educational Credit Union Debit Card. If I currently have an ATM card on
this account, I understand that my Credit Union debit card will replace my ATM card. I realize I must be at least
18 years of age and a member in good standing. I also realize I must have a MECU Draft/Checking account. I am
requesting access to my overdraft line-of-credit.
PLEASE PRINT CLEARLY IN BLACK OR BLUE INK
Name ________________________________________ Credit Union Member Number _________________
Street Address_______________________________________________________________________________
City __________________________________________ State _______________________ Zip _____________
Home Phone __________________________________ Work Phone/Cell Phone _______________________
E-Mail Address ______________________________________________________________________________
Social Security Number _________________________ Date of Birth _________________________________
Employer’s Name & Address__________________________________________________________________
Gross Monthly Income ________________________________________Date Hired ____________________
Joint Applicant Information: Please send an additional card for the Joint Applicant
Name ______________________________________________________________________________________
Street Address (if different) ___________________________________________________________________
City __________________________________________ State _______________________ Zip _____________
Home Phone __________________________________ Work Phone/Cell Phone _______________________
Social Security Number _________________________ Date of Birth _________________________________
Employer’s Name & Address__________________________________________ Date Hired _____________
Our decision to grant this request for a debit card will be based on information provided in this application and
a report from an established credit reporting agency. The result of our decision will be made available to you in
accordance with terms of the Fair Credit Reporting Act and Equal Credit Opportunity Act.*
I/We agree to...
• AlltermsandconditionswhichwereineffectontheoriginalagreementsoftheaccountstowhichI/wewillhave
access through this debit card;
• Anyamendmentstotheseagreementswhichmaybemadefromtimetotime;
• AlltermsandconditionsoutlinedintheEFTDisclosureandTISDisclosureapply;
• Intheeventfundsarenotavailable,standardNSFfeeswillbeassessed.ExcessiveNSFviolationsmayresultin
the Credit Union closing your account.
Use of your debit card will constitute proof of your acceptance of these terms and conditions.
X __________________________________________________________________________________________
Your Signature Date
X __________________________________________________________________________________________
Joint Applicant Signature Date
* If I/we have applied for a Credit Union debit card and do not qualify, please consider this request for an
ATM card.
Withdrawals limited to $500 per day. Duplicate cards $2 each. Duplicate PINs $2 each. All debit card
applications subject to Credit Union approval.
MECU Debit Card Application Form
