Checking Application

After you submit this application, a HFCU employee will contact you. We are required by lay to verify identification when opening a new account.

Personal Information

Please complete the following information EXACTLY as you wish it to appear on your checks.
Primary Name	Joint Name	Account Number
Address	City	State	Zip Code
Additional Information (to appear on checks)	Have you lived in Connecticut for the last five years?	If not list other state(s)	Phone Number
	Yes No		() -Second partThird part

Overdraft Protection Options

You must choose one or more of the following for your overdraft protection. Please enter a "1" for the first priority. If desired, enter "2" for second priority.
Main Share Savings Transfer	Sub-Share Savings Transfer	*Kwik Kash Line of Credit	Overdraft Protection
			Yes No

Primary Owner

Social Security Number	Date of Birth (mm/dd/yy)

Joint Owner

Social Security Number	Date of Birth (mm/dd/yy)

Please enter the security code below prior to submitting the form: