Business records certification and membership forms from a credit union

EFTA00133663¶

Information	Value
P O Box 3205 CSS
New York, NY 10007
Tel: (212) 693-4900
Fax: (212) 238-2700/2701

BUSINESS RECORD CERTIFICATION¶

(Pursuant to C.P.L.R. 3122-a)¶

State of New York )¶

) s.s:¶

County of New York)¶

Our Reference: SUB9316-DJ,¶

Danielle Jones, being duly sworn, deposes and says:¶

1. I am a duly authorized custodian of the attached records and am authorized to make the within certification of behalf of Municipal Credit Union.

2. To the best of my knowledge, after reasonable inquiry, the records or copies thereof are accurate versions of the documents described in the subpoena duces tecum (a copy of which I annexed hereto) that are in the possession, custody, or control of Municipal Credit Union, the recipient of the subpoena.

3. To the best of my knowledge, after reasonable inquiry, the records and copies produced:

□ represent all the documents described in the subpoena duces tecum (or)¶

do not represent a complete set of the documents described in the subpoena duces tecum. The missing documents, and the reason for their absence, are as follows:¶

Description of Missing Document	Reason for Absence
Checks	Not Applicable
Credit Cards Statements	Not Applicable

These records do not contain Suspicious Activity Reports or Currency Transaction Reports. Municipal Credit Union’s BSA Department will respond directly to any request for Suspicious Activity Reports or Currency Transaction Reports.¶

4. The records and copies produced were made by personnel or staff of Municipal Credit Union, or persons acting under their control, in the regular course of business, at the time of the act, transaction, occurrence or event recorded therein, or within a reasonable time thereafter, and that it was in the regular course of Municipal Credit Union’s business to make or maintain these records.

Signature/Date 9/4/19¶

State of New York¶

County of NY¶

Sworn to before me this 4th day of 2019¶

NOTARY PUBLIC¶

PATRICIA GONZALEZ¶

Notary Public, State of New York¶

No.¶

Qualified in Queens County¶

Term Expires April 12, 2022¶

EFTA00133664¶

INFORMATION ON JOINT MEMBER¶

Name			Social Security Number
Home Address	City		State
Work Phone Number	Home Phone		Employer Name
ID Type	ID Number	ID Description	ID Expiry

The undersigned acknowledges receipt of a copy, and agrees to be governed by the rules and regulations of the Municipal Credit Union applicable to Vacation Club Accounts as now in effect and as amended from time to time.¶

Under penalties of perjury, I certify (1) that the number shown on this form is my correct taxpayer identification number; and (2) that I am not s withholding either because I have not been notified that I am subject to backup withholding as a result of failure to report all interest or dividend Revenue Service has notified me that I am no longer subject to backup withholding.¶

SIGNATURE OF PRIMARY MEMBER¶

SIGNATURE OF JOINT MEMBER¶

EFTA00133665¶

Account Number:¶

Basis for Membership:¶

Office Of Probation¶

Please tell us about yourself¶

ChexSystems: Pass¶

Last Name	First Name	Middle Name	Suffix ( Jr. Sr.)
Date of Birth	Social Security Number	Mother’s Maiden Name	Home Phone Number
Street Address (including Apt #)	City	State	ZIP
Mailing Address (including Apt #)	City	State	ZIP
DEPT OF PROBATION	NY	10004	Employer Address
New York	NY	10004	Work Phone Number
@PROBATION.GOV	State	ZIP	Cell Phone Number
Email Address	Re-type Email Address (for verification)
State Drivers Licens	NYSDL	11/01/10
ID 1 Type	ID 1 Number	ID 1 Description	ID 1 Expiration Date
Job Identification	PROBATION	12/31/09
ID 2 Type	ID 2 Number	ID 2 Description	ID 2 Expiration Date
ID 3 Type	ID 3 Number	ID 3 Description	ID 3 Expiration Date

Joint Account Holder¶

☐ ChexSystems¶

Last Name	First Name	Middle Name	Suffix ( Jr. Sr.)
Date of Birth	Social Security Number	Mother’s Maiden Name	Home Phone Number
Street Address (including Apt #)	City	State	ZIP
Mailing Address (including Apt #)	City	State	ZIP
Employer	Employer Address
City	State	ZIP	Work Phone Number
Email Address	Re-type Email Address (for verification)
ID 1 Type	ID 1 Number	ID 1 Description	ID 1 Expiration Date
ID 2 Type	ID 2 Number	ID 2 Description	ID 2 Expiration Date
ID 3 Type	ID 3 Number	ID 3 Description	ID 3 Expiration Date

EFTA00133666¶

Beneficiary Information (optional)¶

Last Name	First Name	Middle Name	Suffix (Jr.Sr.II)
Date of Birth	Social Security Number	Relationship to member	Home Phone Number

SAME¶

Street Address (including Apt#) City State ZIP¶

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Beneficiary Information (optional)¶

Last Name	First Name	Middle Name	Suffix (Jr.Sr.II)
Date of Birth	Social Security Number	Relationship to member	Home Phone Number
Street Address (including Apt#) City State ZIP

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Accounts/Services To Open:¶

• X Shares
• X FasTrack checking
• X ATM/Check Card
• □ Alternative Checking
• □ Money Market
• X Touch Tone Teller
• X MCU OnLine Banking
• X Order Checks

Date: 01/21/09¶

I hereby apply for membership and subscribe for at least one share ($5.00) in the Municipal Credit Union and agree to conform to its By-Laws and amendments thereof. I agree to be governed by the Account Agreement, Rules and Regulations and Schedule of Dividends, Service Charges and Fees of the Municipal Credit Union applicable to Share, FasTrack Checking, Vacation, Holiday and Money Market accounts as now in effect and as from time to time amended. I agree to be bound by the terms and conditions of the MCU Cash Connection, MCU ATM/Check Card, MCU OnLine Banking, and Touch Tone Teller Agreements (which will be later mailed/provided to me), upon my first use of such service(s).¶

I understand that the designations made on this signature card/form will apply to all MCU deposit accounts which are or will be in the future maintained under the same root account number (except IRA, Youth Club, and Share Certificate accounts), and will have the effect of revoking all previous designations made with regard to such accounts.¶

If a joint tenant has been designated on this signature card, it is agreed that these accounts be payable to either of us and upon the death of one of us, to the survivor. Also, it is agreed that any joint tenant may, without the consent of or notice to the other, pledge all or any part of the shares in these accounts as collateral security for a loan with MCU. If a beneficiary (beneficiaries) has (or have) been designated on this signature card, it is agreed that this is a voluntary and revocable trust, and that upon my/our death, the funds in these accounts, and all other deposit accounts maintained under the same root account number (except IRA, Youth Club, and Share Certificate accounts), will become the property of the named beneficiary or beneficiaries who are alive at the time of my/our death in equal proportions. If both a joint tenant and a beneficiary (or beneficiaries) have been designated on this signature card, it is agreed that the beneficiary(ies) will only acquire an interest in these accounts upon the death of the last surviving joint tenant.¶

By signing below, I/We authorize Municipal Credit Union to perform a credit investigation including the verification of the information on this application. Verification of income and employment may also be required.¶

Under penalties of perjury, I certify (1) that the number shown on this form is my correct taxpayer identification number; and (2) that I am not subject to backup withholding either because I have not been notified that I am subject to backup withholding as a result of failure to report all interest or dividends, or because the Internal Revenue Service has notified me that I am no longer subject to backup withholding; and (3) I am a U.S. citizen (including a U.S. resident alien). The Internal Revenue Service does not require your consent to any provision of this document other than the certification required to avoid backup withholding.¶

	01/21/09
Account Holder Signature	Date
Joint Account Holder Signature	Date

If Joint Account Holder requests an MCU ATM/Check Card, check this box.¶

Yes, I elect to accept the Check Imaging option and agree to pay the associated service charge.¶

Brooklyn Branch¶

Sponsor Account Number¶

Branch Name¶

Member Service Representative¶