Agreement and Authorization continued
such checks and drafts for negotiation; and pledging, assigning or granting a security interest in all or part of the funds on deposit to secure any obligation to Taleris Credit Union, Inc. Requests for withdrawal, orders for payment or other transactions on the trust’s account(s) evidenced by a trustee’s signature may be honored even if the trustee omits the title “trustee” from his or her signature or otherwise fails to indicate a representative capacity, the intent being that the trustee is acting in a representative capacity. The authorization and certifications made on this document shall continue in effect until Taleris Credit Union, Inc. receives written notification of a change from a trustee.
Taleris Credit Union, Inc. shall have no duty to inquire about the use or purpose of any transaction unless Taleris Credit Union, Inc. has actual knowledge that a trustee is acting without authority. Taleris Credit Union, Inc. reserves the right to require written consent of all trustees for any transaction on an account, including a transfer or withdrawal of funds, or for a change or termination of an account. If

 	Check Ordering	

To order checks, fill in completely. Print exactly as you want your checks to be printed. (When ordering checks, please include a check, money order or transfer to cover the cost of your checks.)

Account Name(s)

Street Address

Living Trust Account Card

Taleris Credit Union, Inc. receives notice concerning a dispute over	 	

an account or inconsistent instructions from trustees, Taleris Credit Union, Inc. may suspend or terminate the account or require a court order or written consent from all trustees to act. The trustee(s), personally and as representative for the trust, agrees to indemnify and hold Taleris Credit Union, Inc. harmless from any and all claims, suits, actions, damages, judgments, liabilities, losses, costs, charges and expenses, including court costs and attorney’s fees that Taleris Credit Union, Inc. shall or may sustain resulting from a trustee’s miscon-  duct or misrepresentation. Successor trustee(s) shall assume the role and responsibilities of the trustee according to provisions set forth in separate document(s) creating and governing the trust. Successor trustees must provide evidence documenting authority to assume the role and responsibilities of a trustee. On behalf of the above named trust, the trustee(s) signed below agrees to the terms and conditions contained herein and of the Membership and Account Agreement, Truth-in-Savings Disclosure, Funds Availability Policy Disclosure, and Privacy Notice Disclosure, as applicable and to any amendments Taleris Credit Union, Inc. makes from time to time. The trustee acknowledges receipt of a copy of the Agreement and Disclosures applicable to the accounts and services requested herein. If an access card or EFT service is requested and pro- vided, the trustee agrees to the terms of and acknowledges receipt of the Electronic Funds Transfer Agreement. This agreement and authorization includes the certification on the reverse side of this form.

X
Trustee Signature	Date

X  	
Trustee Signature	Date

 	TCU Use Only	

City	State	Zip

Telephone Number (optional)

Check Number Starting At (#101 or higher)

Check Style	Cover	Lettering

 	Personal Identification Number	

Choose your own TCU MasterMoney™ Debit Card or TCU24 ATM Card PIN number below.
TCUMasterMoney™Debit Card	TCU24 ATMCard
You must select your own PIN. The PIN will not be provided for you. No Q or Z please. Please select all numbers or all letters.
TRUSTEE	TRUSTEE

ADDITIONAL TRUSTEE
   
Signature of Trustee  	 Signature of Trustee  	

SSN Issue Date

ChexSystems Record

State	Signature of Trustee  	

Date	Institution	Reason

Date	Institution	Reason

OUR SAVINGS INSURED TO $250,000 PER ACCOUNT. This institution is not federally insured, and if the institution fails,
 the Federal Government does not guarantee that depositors will get back their money. MEMBERS’ACCOUNTS ARE NOT INSURED OR 
GUARANTEED BY ANY GOVERNMENT OR GOVERNMENT-SPONSORED AGENCY

/MD0.043 08/20/19	 	

Account Number

Living Trust Account Card

 	Account Type	

On behalf of the trust named below, the trustee(s) signed hereon request membership for the trust in Taleris Credit Union, Inc. and request to open the following accounts:
Share/Savings	Money Market
Share Draft/Checking	Other
Share Certificate	Other

Trustee	 SSN  	
Date of Birth  	 Driver’sLic. No.   	 Eligibility for Membership  	
 	Grantor Trustee	
Name of Grantor  		 Same as trustee	Different from trustee

 	TIN Certification and Backup Information	

Under penalties of perjury, the trustee(s) signed on this form certify that:
1.	The number shown on this form is the correct taxpayer identific tion number for the trust or I am waiting for a number to be issued, and
2.	The payee of dividend earnings is not subject to backup withholding because: (a) the payee is exempt from backup withholding, or (b) the payee has not been notified by the Internal Revenue Service (IRS) that the payee is subject to backup withholding as a result of a failure to report all interest or dividends, or (c) the IRS has notified the dividend payee that the payee is no longer subject to backup withholding, and
3.	The dividend payee is a U.S. person (including a U.S. resident alien
1.	
Eligibility for membership if Grantor different from trustee
 	A C C OU N T  S E R VI C E S		 	

Or
The dividend payee is not a U.S. Citizen or resident alien.

PayrollDeduction/Direct Deposit Debit Card
E-statements

Other 	

ATM Card Teller 24 Teller 24e PBill Payment
Mobile Banking

Name of Grantor  	
Same as trustee	Different from trustee

Complete IRS Form W8BEN)
The dividend payee is subject to backup withholding
The Internal Revenue Service does not require consent to any provision of this document other than the certifications required to avoid backup withholding.

Living Trust Membership Application and Ownership

Signature 	Date	 Signature 	Date  	

Account Title  	 Street	 City/State/Zip	 Trust EIN 	  Cell phone    	 Home Phone  	 Work Phone 	
 	Trustee Information	

Trustee	 SSN    	
Date of Birth  	 Driver’sLic. No. 	 Eligibility for Membership  	

 	Successor Trustee(s)	

Name of Successor Trustee   	 Social Security Number  	 Name of Successor Trustee  	 Social Security Number  	
 	Beneficiary Information	

Beneficiary	 Social Security Number  	

Beneficiary	 Social Security Number  	

Beneficiary	 Social Security Number  	

 	Trustee Certifications	
By signing below, the trustee (whether one or more) certifies that he/ she is a trustee for the living trust named on this document and is authorized to establish accounts at Taleris Credit Union, Inc. to which funds belonging to the named living trust shall be deposited. Under the terms of the document(s) creating and governing the trust, any one trustee (including a successor trustee that has assumed the role of trustee) is authorized without limitation to make any instruction or execute any transaction on an account owned by the trust as if the trustee owned the account personally and alone. The trustee certifies that the terms of the trust documents are not in conflict with any term contained in this document. In addition, the trustee certifies that he/she is authorized to execute any additional agreement(s) necessary to make a transaction or cause the Taleris Credit Union, Inc. to follow an instruction or order.

 	Agreement and Authorization	
The accounts listed under the Account Type section are owned solely by the living trust named hereon. Upon request of Taleris Credit Union, Inc., the trustee (whether one or more) signed below, agrees to provide complete copies of all trust documents including any amendments. All statements and notices regarding accounts will be mailed to the address listed for the trust unless the credit union receives written notification of a different address. Taleris Credit Union, Inc. is authorized to comply with the direction of any one trustee concerning any transaction or instruction on an account. This authorization includes, but is not limited to: complying with orders in writing, by telephone or electronically for the transfer or withdrawal of funds; certifying or paying funds to any party by draft, check, internal or electronic transfer; cashing checks and drafts payable to the trust and endorsed by any one trustee, dispersing a portion of any deposit of such checks and drafts in cash or accepting (over please)