Membership Application

(*) indicates a required field

We look forward to helping you become a member at ILWU Credit Union! To complete this application quickly and efficiently, we suggest you have the following documents available before proceeding:

A copy of a valid or non-expired state-issued identification card (or driver’s license) in a JPEG or PDF format
A copy of a recent utility bill, paystub or W-2 in case your current address doesn't match your driver's license or state-issued ID
A signed W-8 BEN in case you're not a US citizen
In order to open your account, you will need to deposit a minimum of $6 ($5 initial share deposit and $1 one-time membership fee). We will collect this fee once you have completed the application.

Please make sure any documents are saved as a JPEG or PDF with a maximum file size of 5MB. Please contact us if you have any questions!

Disclosures:

USA Patriot Act Notice: 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. 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 will also ask to see your driver’s license or other identifying documents.

Please acknowledge you have read and accept the disclosures.*

Yes, I've read and accept the Disclosures.

You must agree to the disclosures to proceed!

Select the Products You Would Like to Open with Your Membership

Account Type(s)*

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Checking Options*

Debit Card

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Account Ownership*

Individual

Joint

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Membership Eligibility

Please select one and provide eligibility information.

Your Eligibility*

ILWU Local

Member Sponsor

Other

You must select one

ILWU Local Info*

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Other (Please Explain)*

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Relationship

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Member Number

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Primary Owner Information

First Name*

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Middle Name

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Last Name*

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Suffix

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Social Security Number/TIN*

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Birthdate (MM/DD/YYYY)*

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School ID# or SSN*

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Driver License or ID No.*

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Mother's Maiden Name*

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Home Address (PO Box will not be accepted as a home address.)*

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City*

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Select State*

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Zip Code*

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Is your mailing address different from your home address?

Yes

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Mailing Address*

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City*

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Select State*

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Zip Code*

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E-Mail Address*

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Cell Phone Number*

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If you are unemployed, retired or a student, please enter UNEMPLOYED/STUDENT/RETIRED in both the Employer Name and Occupation fields.

Employer Name*

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Occupation*

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Upload a copy of your ID (Driver's License or State-Issued ID or Passport)*

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Upload a copy of your Student ID/SSN*

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Is the address on your ID current?*

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If the address on your ID is not current, please select one of these document types and upload them here.

Proof of residence documentation*

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Upload a copy of proof of residence*

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Upload a copy of your Employee ID or most recent paystub

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Joint Owner Information

First Name*

Invalid Input

Middle Name

Invalid Input

Last Name*

Invalid Input

Suffix

Invalid Input

Social Security Number*

Invalid Input

Birthdate (MM/DD/YYYY)*

Invalid Input

Driver License or ID No.*

Invalid Input

Mother's Maiden Name*

Invalid Input

Is your home address different from the primary account holder?

Yes

Invalid Input

Home Address (PO Box will not be accepted as a home address.)*

Invalid Input

City*

Invalid Input

Select State*

Invalid Input

Zip/Postal Code*

Invalid Input

Is your mailing address different from your home address?

Yes

Invalid Input

Mailing Address*

Invalid Input

City*

Invalid Input

Select State*

Invalid Input

Zip/Postal Code*

Invalid Input

E-Mail Address*

Invalid Input

Cell Phone Number*

Invalid Input

If you are unemployed, retired or a student, please enter UNEMPLOYED/STUDENT/RETIRED in both the Employer Name and Occupation fields.

Employer Name

Invalid Input

Occupation

Invalid Input

Upload a copy of your ID (Driver's License or State-Issued ID or Passport)*

Invalid Input

Is the address on your ID current?*

Invalid Input

If the address on your ID is not current, please select one of these document types and upload them here.

Proof of residence documentation*

Invalid Input

Upload a copy of proof of residence*

Invalid Input

Upload a copy of your Employee ID or most recent paystub

Invalid Input

Add Another Joint?*

Yes

No

Invalid Input

Second Joint Owner Information

First Name*

Invalid Input

Middle Name

Invalid Input

Last Name*

Invalid Input

Suffix

Invalid Input

Social Security Number*

Invalid Input

Birthdate (MM/DD/YYYY)*

Invalid Input

Driver License or ID No.*

Invalid Input

Mother's Maiden Name*

Invalid Input

Is your home address different from the Primary Account Holder?

Yes

Invalid Input

Home Address (PO Box will not be accepted as a home address.)*

Invalid Input

City*

Invalid Input

Select State*

Invalid Input

Zip/Postal Code*

Invalid Input

Is your mailing address different from your home address?

Yes

Invalid Input

Mailing Address*

Invalid Input

City*

Invalid Input

Select State*

Invalid Input

Zip/Postal Code*

Invalid Input

E-Mail Address*

Invalid Input

Cell Phone Number*

Invalid Input

If you are unemployed, retired or a student, please enter UNEMPLOYED/STUDENT/RETIRED in both the Employer Name and Occupation fields.

Employer Name

Invalid Input

Occupation

Invalid Input

Upload a copy of your ID (Driver's License or State-Issued ID or Passport)*

Invalid Input

Is the address on your ID current?*

Invalid Input

If the address on your ID is not current, please select one of these document types and upload them here.

Proof of residence documentation*

Invalid Input

Upload a copy of proof of residence*

Invalid Input

Upload a copy of your Employee ID or most recent paystub

Invalid Input

Payable-On-Death Account (P.O.D)/Beneficiary Designation

Upon the death of the last surviving owner of a pay-on-death account, any sums remaining belong to the designated pay-on-death (P.O.D.) payee or payees surviving the owner in equal and undivided shares. Joint owners should not be named as P.O.D. beneficiaries. Pay-on-death payee designation applies to all accounts I open on the Card unless otherwise indicated in writing.

Number of beneficiaries

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Beneficiary Name*

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Birthdate (MM/DD/YYYY)*

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Social Security Number

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Beneficiary Address (Enter Full Address)

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Phone Number*

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Name of 2nd Beneficiary*

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Birthdate (MM/DD/YYYY)*

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Social Security Number of 2nd Beneficiary

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Address of 2nd Beneficiary (Enter Full Address)

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Phone Number for 2nd Beneficiary*

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Do you want to add more beneficiaries?

Yes

No

Invalid Input

Membership Application

Select the Products You Would Like to Open with Your Membership

Membership Eligibility

Primary Owner Information

Joint Owner Information

Second Joint Owner Information

Payable-On-Death Account (P.O.D)/Beneficiary Designation

Additional Products

Taxpayer Identification and Backup Withholding

Authorization

Please note