Kearney Federal Credit Union

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Enrollment Form

When you complete this form, please do not include your account number or your social security number.

Member/Owner	Member Name
Street
City/State/Zip	Driver's Lic. No.
Home Phone	Date of Birth
Work Phone	Email

Terms of Use Agreement By submitting this form to the Kearney Federal Credit Union, you promise that everything you have stated in this application is correct to the best of your knowledge and that the above information is a complete listing of what you owe. If there are any important changes you will notify us in writing immediately. You authorize the credit union to obtain credit reports in connection with this application for credit and for any update, renewal, or extension of credit received. You understand that the credit union will rely on the information in this application and your credit report to make its decision. If you request, the credit union will tell you the name and address of any credit bureau from which it received a credit report on you. It is a federal crime to willfully and deliberately provide incomplete or incorrect information on loan applications made to federal credit unions or state chartered credit unions insured by NCUA.

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