Authorization for CU Online (online banking) service

- - - - - - - - - - - - - -PLEASE PRINT AND RETURN TO SAINT AGNES FEDERAL CREDIT UNION - - - - - - - - - - - - -

Member Name: __________________________________________________ Member #: ______________________

Address: __________________________________________________________________________________________

City: _________________________________________________________ State: __________ ZIP:_______________

Home Phone: (_____)__________________________ Work Phone: (_____)_________________________________
Cell Phone: (_____)____________________________

Email Address: ____________________________________________________________________________________
(Required for enrollment notification. Please print legibly to avoid delays.)

________Please sign me up for CU Online (online banking).
All shares and loans under the member number listed above will be accessible.

Other accounts I wish to transfer into are:

Name: _____________________________________________________________ Member #:__________________

Name: _____________________________________________________________ Member #:_________________

Name: _____________________________________________________________ Member #:_________________

If you have a Saint Agnes checking account, you can enroll in our Bill Pay service. After you've logged in to CU Online,
click on the Bill Payer button to get started.

I agree to receive all agreements and initial disclosures electronically. After I have carefully read the agreement in its
entirety, I will be asked to consent to the terms and conditions of the agreement.

Signature:__________________________________________________________ Date: _______________________
(Member only must sign.)

Please drop off this completed application at either branch office or mail to: Saint Agnes Federal Credit Union, Attn:
Marketing, 716 Maiden Choice Lane, Suite 101, Baltimore, MD 21228, or FAX to 410-869-8293. You will be notified by e-mail
when your service is activated.