CU Online/E-Statements Sign-Up Form

To sign up for these exciting free services:
1. Complete, print, and sign application.
2. Return your application to Capital Credit Union,
    PO Box 2096, Bismarck, ND 58502.

I am signing up for (please check all that apply):

 CU Online         E-Statements        
Personal Information

Name:
Daytime Phone# :
E-Mail Address:
Account Number:
Additional accounts that I wish to access with CU Online (you must have identical ownership on all accounts requested).

1.
                Account Number
 
2.
                Account Number
Additional accounts that I wish to have e-mailed
1.
                Account Number
 
2.
                Account Number

Terms & Conditions

This disclosure is pursuant to the Federal Electronics Funds Transfer Regulation. Use of CU Online and/or E-Statements is subject to the regulations covering the rights and liabilities of the user. If privileges are abused as determined by Capital Credit Union, the credit union has the right to discontinue use of these products. By submitting this form, I authorize Capital Credit Union to deliver my account information electronically. I understand that all statement information will be compressed, encrypted, and password-protected for my security. I also understand that I may receive additional messages from the credit union. I understand that I am responsible to alert the credit union of any changes in my e-mail address. Your consent for CU Online and/or E-Statements applies to your account from now on, unless you contact the credit union to do otherwise. You always have the right to receive your account information on paper. If you wish to discontinue receiving your account information electronically, please contact the credit union. By discontinuing to have your account information delivered electronically, you may become ineligible for certain electronically-based accounts, such as E-Checking. If you wish to have a paper copy of your statement but wish to continue on E-Statements, there will be a small fee (please see fee schedule). CU Online system requirements include: a computer with at least a 486 processor, a modem with at least 28.8 Kbps, internet access and one of our two supported browsers, either Netscape Navigator 4.7 or Microsoft Internet Explorer 5.0 or higher. E-Statements system requirements include: internet access and the free Adobe Acrobat Reader. Acrobat Reader can be downloaded free at our site - www.capcu.org
 

We must have your signature on this form to process this information.
 
 
Signature: Date:



 

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