Applicant Information

Eligibility

Membership in Northpark Community Credit Union is open to the following individuals:




•     Employees and retirees of Corteva Agriscience Companies Worldwide and their families.




•     Those who live or work in Bartholomew, Boone, Brown, Clinton, Hamilton, Hancock, Hendricks, Henry, Johnson, Madison, Monroe, Montgomery, Morgan, Owen, Putnam, Rush, Shelby and Tipton Counties or in the following townships of Marion County (Center, Decatur, Lawrence, Perry, Pike, Warren, Washington, and Wayne), as well as their family members.




•     Employees of approved Business Partners and their families




You must also open and maintain a Share Savings account with a minimum balance of $5.

• Before proceeding, please confirm your eligibility below:

  • I am eligible for membership in NPCCU by reason of employment, membership, affiliation, association, and/or other relationshipwith the organization, institution, corporation, or entity included in the Credit Union's field of membership as outlined above.
  • I Iive or work in Bartholomew, Boone, Brown, Clinton, Hamilton, Hancock, Hendricks, Henry, Johnson, Madison, Monroe, Montgomery, Morgan, Owen, Putnam, Rush, Shelby or Tipton Counties or in the following townships of Marion County (Center, Decatur, Lawrence, Perry, Pike, Warren, Washington, and Wayne)
  OK Before proceeding, please confirm your eligibility below: is required
• Please enter the zip code where you live or work.
  OK Please enter the zip code where you live or work. is required
• • By checking this box, I confirm I understand that I must open and maintain a share savings account with a minimum balance of $5 as a requirement of membership in NPCCU.
  OK By checking this box, I confirm I understand that I must open and maintain a share savings account with a minimum balance of $5 as a requirement of membership in NPCCU. is required

• Please enter the code to confirm your ability to view the required Portable Document Format (PDF) files. If the code isn't visible, click here to see code in new window or visit your nearest branch to apply for an account.

  We ask that you confirm your ability to download, open, and view the required Portable Document Format (PDF) files. Once you have entered the confirmation code, you may close the PDF document and continue the application process.

  
  

  Click here for your confirmation code.

• Enter code
  OK Error - Please enter the code to verify that you can view the required Portable Document Format (PDF) files. If the code isn't visible you will need to visit your nearest branch to apply for an account.

Basic Info

• First Name
  OK First Name is required
• Last Name
  OK Last Name is required
• Email Address
  OK Email Address is required
• Phone
  OK Phone is required
• Date of Birth
  OK Date of Birth is required
• Social Security Number
  OK Social Security Number is required

Address

• Address
  OK Address is required
• City
  OK City is required
• State AK - AlaskaAL - AlabamaAR - ArkansasAZ - ArizonaCA - CaliforniaCO - ColoradoCT - ConnecticutDC - District of ColumbiaDE - DelawareFL - FloridaGA - GeorgiaHI - HawaiiIA - IowaID - IdahoIL - IllinoisIN - IndianaKS - KansasKY - KentuckyLA - LouisianaMA - MassachusettsMD - MarylandME - MaineMI - MichiganMN - MinnesotaMO - MissouriMS - MississippiMT - MontanaNC - North CarolinaND - North DakotaNE - NebraskaNH - New HampshireNJ - New JerseyNM - New MexicoNV - NevadaNY - New YorkOH - OhioOK - OklahomaOR - OregonPA - PennsylvaniaRI - Rhode IslandSC - South CarolinaSD - South DakotaTN - TennesseeTX - TexasUT - UtahVA - VirginiaVT - VermontWA - WashingtonWI - WisconsinWV - West VirginiaWY - Wyoming
  OK State is required
• Zip Code
  OK Zip Code is required
• • Mailing address is different (Optional)
  OK Mailing address is different (Optional) is required

Mailing Address

• Address
  OK Address is required
• City
  OK City is required
• State AK - AlaskaAL - AlabamaAR - ArkansasAZ - ArizonaCA - CaliforniaCO - ColoradoCT - ConnecticutDC - District of ColumbiaDE - DelawareFL - FloridaGA - GeorgiaHI - HawaiiIA - IowaID - IdahoIL - IllinoisIN - IndianaKS - KansasKY - KentuckyLA - LouisianaMA - MassachusettsMD - MarylandME - MaineMI - MichiganMN - MinnesotaMO - MissouriMS - MississippiMT - MontanaNC - North CarolinaND - North DakotaNE - NebraskaNH - New HampshireNJ - New JerseyNM - New MexicoNV - NevadaNY - New YorkOH - OhioOK - OklahomaOR - OregonPA - PennsylvaniaRI - Rhode IslandSC - South CarolinaSD - South DakotaTN - TennesseeTX - TexasUT - UtahVA - VirginiaVT - VermontWA - WashingtonWI - WisconsinWV - West VirginiaWY - Wyoming
  OK State is required
• Zip Code
  OK Zip Code is required

Previous Address

• Have you lived at this address for less than 2 years?

  • No
  • Yes
  OK You must select one of the following.
• Previous Address
  OK Previous Address is required
• City
  OK City is required
• State AK - AlaskaAL - AlabamaAR - ArkansasAZ - ArizonaCA - CaliforniaCO - ColoradoCT - ConnecticutDC - District of ColumbiaDE - DelawareFL - FloridaGA - GeorgiaHI - HawaiiIA - IowaID - IdahoIL - IllinoisIN - IndianaKS - KansasKY - KentuckyLA - LouisianaMA - MassachusettsMD - MarylandME - MaineMI - MichiganMN - MinnesotaMO - MissouriMS - MississippiMT - MontanaNC - North CarolinaND - North DakotaNE - NebraskaNH - New HampshireNJ - New JerseyNM - New MexicoNV - NevadaNY - New YorkOH - OhioOK - OklahomaOR - OregonPA - PennsylvaniaRI - Rhode IslandSC - South CarolinaSD - South DakotaTN - TennesseeTX - TexasUT - UtahVA - VirginiaVT - VermontWA - WashingtonWI - WisconsinWV - West VirginiaWY - Wyoming
  OK State is required
• Zip Code
  OK Zip Code is required

Identification

• What form of ID would you prefer to use?

  • Drivers license or state-issued ID
  • US Passport
  OK What form of ID would you prefer to use? is required
• License Number
  OK License Number is required
• State AK - AlaskaAL - AlabamaAR - ArkansasAZ - ArizonaCA - CaliforniaCO - ColoradoCT - ConnecticutDC - District of ColumbiaDE - DelawareFL - FloridaGA - GeorgiaHI - HawaiiIA - IowaID - IdahoIL - IllinoisIN - IndianaKS - KansasKY - KentuckyLA - LouisianaMA - MassachusettsMD - MarylandME - MaineMI - MichiganMN - MinnesotaMO - MissouriMS - MississippiMT - MontanaNC - North CarolinaND - North DakotaNE - NebraskaNH - New HampshireNJ - New JerseyNM - New MexicoNV - NevadaNY - New YorkOH - OhioOK - OklahomaOR - OregonPA - PennsylvaniaRI - Rhode IslandSC - South CarolinaSD - South DakotaTN - TennesseeTX - TexasUT - UtahVA - VirginiaVT - VermontWA - WashingtonWI - WisconsinWV - West VirginiaWY - Wyoming
  OK State is required
• Issued Date
  OK Issued Date is required
• Expiration Date
  OK Expiration Date is required
• Passport Number
  OK Passport Number is required
• Expiration Date
  OK Expiration Date is required

Tax Status

• • I am not subject to backup withholding. This is most common. Under penalties of perjury, I certify that 1. My Social Security number is correct, 2. I am not subject to backup withholding because (a) I am exempt from backup withholding, (b) I have not been notified by the Internal Revenue Service (IRS) that I am subject to backup withholding as a result of a failure to report all interest or dividends, or (c) the IRS has notified me that I am no longer subject to backup withholding, 3. I am a U.S. citizen or U.S. resident alien, and 4. I am exempt from FATCA reporting.
  • I am subject to backup withholding. You will know if this applies to you. Under penalties of perjury, I certify that 1. My Social Security number is correct, 2. I am subject to backup withholding because I have been notified by the Internal Revenue Service (IRS) that I am subject to backup withholding as a result of a failure to report all interest or dividends, 3. I am a U.S. person or U.S. resident alien, and 4. I am exempt from FATCA reporting.
  OK Please select one of the following.

What is this?

If you have any questions about how to complete this section please download instructions.

Beneficiary Information

• Would you like to add a beneficiary to this account?

  • Yes
  • No
  OK Would you like to add a beneficiary to this account? is required

• Account Designations

  • Payable on Death (POD)/Trust Account
  • All Accounts
  • Designate Specific Accounts
  OK Account Designations is required
• Account
  OK Account is required
• • Beneficiary 1
  OK Beneficiary 1 is required
• Name
  OK Name is required
• Date of Birth
  OK Date of Birth is required
• Social Security Number
  OK Social Security Number is required
• Address
  OK Address is required
• City
  OK City is required
• State
  OK State is required
• Zip code
  OK Zip code is required
• Phone Number
  OK Phone Number is required
• Email
  OK Email is required
• • Beneficiary 2
  Optional OK Beneficiary 2 is required
• Name
  OK Name is required
• Date of Birth
  OK Date of Birth is required
• Social Security Number
  OK Social Security Number is required
• Address
  OK Address is required
• City
  OK City is required
• State
  OK State is required
• Zip code
  OK Zip code is required
• Phone Number
  OK Phone Number is required
• Email
  OK Email is required

Additional Information

• Primary Owners Employer
  OK Primary Owners Employer is required
• Occupation
  OK Occupation is required
• Title
  OK Title is required
• Work Phone Number
  OK Work Phone Number is required
• Security Code -This code will be used for security purposes when you call into the branch to request information about your account.
  OK Security Code -This code will be used for security purposes when you call into the branch to request information about your account. is required

• Would you like to be enrolled for Bill Payment?

  • Yes
  • No
  OK Would you like to be enrolled for Bill Payment? is required

• Would you like to activate a daily Debit Card Round Up to the nearest $1 to sweep to your savings?

  • Yes
  • No
  OK Would you like to activate a daily Debit Card Round Up to the nearest $1 to sweep to your savings? is required

• Would you like to enroll in eStatements to meet monthly reward qualifications?

  • Yes
  • No
  OK Would you like to enroll in eStatements to meet monthly reward qualifications? is required

• Would you like to set-up auto transfers from Savings to Checking if funds are needed to cover a partial/full transaction?

  • Yes
  • No
  OK Would you like to set-up auto transfers from Savings to Checking if funds are needed to cover a partial/full transaction? is required
• How did you learn about NorthPark Community Credit Union? I already have a savings account, but no checking accountI already have a loan, but no checking accountWeb search - CheckingWeb search - CD RatesWeb search - Free CheckingWeb search - OtherReferred by a friendReferred by a co-workerYou visited my employerOne of your employees told me about online account opening.ENews received by credit unionMailer received by credit unionSocial Media
  OK How did you learn about NorthPark Community Credit Union? is required
• Best Time to Call/Contact
  OK Best Time to Call/Contact is required
• Preferred Contact Method PhoneEmail
  OK Preferred Contact Method is required

• What is your preferred language for future communications?

  • English
  • Spanish
  • Other
  OK What is your preferred language for future communications? is required
• Please enter your preferred language:
  Optional OK Please enter your preferred language: is required
• Member Referral Code
  Optional OK Member Referral Code is required

Joint Applicant

• Will this be a joint account?

  • No, I am the only applicant
  • Yes, I have a co-applicant
  OK Will this be a joint account? is required

Co-Applicant Basic Info

• First Name
  OK First Name is required
• Last Name
  OK Last Name is required
• Email
  OK Email is required
• Phone
  OK Phone is required
• Date of Birth
  OK Date of Birth is required
• Social Security Number
  OK Social Security Number is required

Co-Applicant Address

• Address
  OK Address is required
• City
  OK City is required
• State AK - AlaskaAL - AlabamaAR - ArkansasAZ - ArizonaCA - CaliforniaCO - ColoradoCT - ConnecticutDC - District of ColumbiaDE - DelawareFL - FloridaGA - GeorgiaHI - HawaiiIA - IowaID - IdahoIL - IllinoisIN - IndianaKS - KansasKY - KentuckyLA - LouisianaMA - MassachusettsMD - MarylandME - MaineMI - MichiganMN - MinnesotaMO - MissouriMS - MississippiMT - MontanaNC - North CarolinaND - North DakotaNE - NebraskaNH - New HampshireNJ - New JerseyNM - New MexicoNV - NevadaNY - New YorkOH - OhioOK - OklahomaOR - OregonPA - PennsylvaniaRI - Rhode IslandSC - South CarolinaSD - South DakotaTN - TennesseeTX - TexasUT - UtahVA - VirginiaVT - VermontWA - WashingtonWI - WisconsinWV - West VirginiaWY - Wyoming
  OK State is required
• Zip Code
  OK Zip Code is required
• • Mailing address is different
  Optional OK Mailing address is different is required

Co-Applicant Mailing Address

• Address
  OK Address is required
• City
  OK City is required
• State AK - AlaskaAL - AlabamaAR - ArkansasAZ - ArizonaCA - CaliforniaCO - ColoradoCT - ConnecticutDC - District of ColumbiaDE - DelawareFL - FloridaGA - GeorgiaHI - HawaiiIA - IowaID - IdahoIL - IllinoisIN - IndianaKS - KansasKY - KentuckyLA - LouisianaMA - MassachusettsMD - MarylandME - MaineMI - MichiganMN - MinnesotaMO - MissouriMS - MississippiMT - MontanaNC - North CarolinaND - North DakotaNE - NebraskaNH - New HampshireNJ - New JerseyNM - New MexicoNV - NevadaNY - New YorkOH - OhioOK - OklahomaOR - OregonPA - PennsylvaniaRI - Rhode IslandSC - South CarolinaSD - South DakotaTN - TennesseeTX - TexasUT - UtahVA - VirginiaVT - VermontWA - WashingtonWI - WisconsinWV - West VirginiaWY - Wyoming
  OK State is required
• Zip Code
  OK Zip Code is required

Co-Applicant Previous Address

• Have you lived at this address for less than 2 years?

  • No
  • Yes
  OK You must select one of the following.
• Previous Address
  OK Previous Address is required
• City
  OK City is required
• State AK - AlaskaAL - AlabamaAR - ArkansasAZ - ArizonaCA - CaliforniaCO - ColoradoCT - ConnecticutDC - District of ColumbiaDE - DelawareFL - FloridaGA - GeorgiaHI - HawaiiIA - IowaID - IdahoIL - IllinoisIN - IndianaKS - KansasKY - KentuckyLA - LouisianaMA - MassachusettsMD - MarylandME - MaineMI - MichiganMN - MinnesotaMO - MissouriMS - MississippiMT - MontanaNC - North CarolinaND - North DakotaNE - NebraskaNH - New HampshireNJ - New JerseyNM - New MexicoNV - NevadaNY - New YorkOH - OhioOK - OklahomaOR - OregonPA - PennsylvaniaRI - Rhode IslandSC - South CarolinaSD - South DakotaTN - TennesseeTX - TexasUT - UtahVA - VirginiaVT - VermontWA - WashingtonWI - WisconsinWV - West VirginiaWY - Wyoming
  OK State is required
• Zip Code
  OK Zip Code is required

Co-Applicant Identification

• What form of ID would you prefer to use?

  • Drivers license or state-issued ID
  • US Passport
  OK What form of ID would you prefer to use? is required
• License Number
  OK License Number is required
• State AK - AlaskaAL - AlabamaAR - ArkansasAZ - ArizonaCA - CaliforniaCO - ColoradoCT - ConnecticutDC - District of ColumbiaDE - DelawareFL - FloridaGA - GeorgiaHI - HawaiiIA - IowaID - IdahoIL - IllinoisIN - IndianaKS - KansasKY - KentuckyLA - LouisianaMA - MassachusettsMD - MarylandME - MaineMI - MichiganMN - MinnesotaMO - MissouriMS - MississippiMT - MontanaNC - North CarolinaND - North DakotaNE - NebraskaNH - New HampshireNJ - New JerseyNM - New MexicoNV - NevadaNY - New YorkOH - OhioOK - OklahomaOR - OregonPA - PennsylvaniaRI - Rhode IslandSC - South CarolinaSD - South DakotaTN - TennesseeTX - TexasUT - UtahVA - VirginiaVT - VermontWA - WashingtonWI - WisconsinWV - West VirginiaWY - Wyoming
  OK State is required
• Issued Date
  OK Issued Date is required
• Expiration Date
  OK Expiration Date is required
• Passport Number
  OK Passport Number is required
• Expiration Date
  OK Expiration Date is required

Co-Applicant Tax Status

• • I am not subject to backup withholding. This is most common. Under penalties of perjury, I certify that 1. My Social Security number is correct, 2. I am not subject to backup withholding because (a) I am exempt from backup withholding, (b) I have not been notified by the Internal Revenue Service (IRS) that I am subject to backup withholding as a result of a failure to report all interest or dividends, or (c) the IRS has notified me that I am no longer subject to backup withholding, 3. I am a U.S. citizen or U.S. resident alien, and 4. I am exempt from FATCA reporting.
  • I am subject to backup withholding. You will know if this applies to you. Under penalties of perjury, I certify that 1. My Social Security number is correct, 2. I am subject to backup withholding because I have been notified by the Internal Revenue Service (IRS) that I am subject to backup withholding as a result of a failure to report all interest or dividends, 3. I am a U.S. person or U.S. resident alien, and 4. I am exempt from FATCA reporting.
  OK Please select one of the following.

What is this?

If you have any questions about how to complete this section please download instructions.

Co-Applicant Additional Information

• Employer
  OK Employer is required
• Occupation
  OK Occupation is required
• Title
  OK Title is required
• Security Code -This code will be used for security purposes when you call into the branch to request information about your account.
  OK Security Code -This code will be used for security purposes when you call into the branch to request information about your account. is required

Important Information About Procedures for Opening a New Account:

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. What this means for you: 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 may also ask to see your driver's license or other identifying documents.