Artesian City Federal Credit Union

ATM CARD APPLICATION

Click here to view ATM AGREEMENT

NAME 1 PRIMARY MEMBER

DATE

NAME 2 JOINT MEMBER

ADDRESS

CITY

STATE

ZIP

ACCOUNTS DESIRED TO BE ACCESSED

Share Draft Account #

Share Account #

_______________________________
Signature 1

FOR OFFICE USE ONLY

AUTHORIZED BY

DATE

CARD NUMBER

WD LMT.

_______________________________
Signature 2

Note:
Your "PIN" must be selected when application is submitted.
Two signatures are required to receive two cards.
Signature(s) os applicant(s) acknowledge receipt of disclosures as required by the Electronic Funds Transfer Act (Regulation E).

BRING APPLICATION TO:

Artesian City federal Credit Union
100 Flint Avenue
Albany, Georgia 31701

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