Membership & Deposit Application

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Mazuma Membership and Deposit Products Application

To become a member, simply deposit twenty-five dollars into a savings (share) account and complete our online membership application, or stop by one of our offices and join us today. You'll be amazed at the difference membership makes! You can be a member if you live or work in Jackson or Clay County.

By using this online form, you can also apply for a Mazuma checking account, certificate of deposit, individual retirement account or money market account. Please fill in this form and press the Print Preview button at the bottom of the page.

To protect your privacy, NO information is sent over the Internet.

When you hit Print Preview, this will create a new window on your screen with all of the information that you have entered. If the information looks correct, please PRINT the form, sign, date and initial it, then mail or bring it to the Mazuma Credit Union office nearest you. (To view Mazuma's complete Privacy Policy Statement, please click here.)

New Members: Please complete the form below and bring it or mail it, with an initial deposit of $25,* a copy of your driver's license plus a copy of a second ID, to any Mazuma Credit Union office. (Mailing address: Attn: Financial Services, 9300 Troost Ave., Kansas City, MO 64131-3000.)

Fields with an * next to them are required fields. Information must be provided in order to complete form processing.

*I am applying for the following account(s):
Savings
Regular Share Savings	Special Share Savings
Holiday Share Savings	IRA Share Savings
Money Bunny Club	fyi Only Club
Checking
Classic Checking	Signature Checking
Premier Checking
Money Market
Classic Money Market	Signature Money Market
Premier Money Market
Individual Retirement
Classic IRA	Signature IRA
Premier IRA
Certificates of Deposit
Classic CD	Signature CD
Premier CD	Deposit CD
Jump-Up CD	Wealth Builder CD
Young Investor's CD	Retirement Access CD

Applicant Information
*First Name, M.I.	*Last Name
*Account Number	*SS No. or Tax I.D.
*Street Address	*City
*State	*Zip Code
Home Phone No.	Work Phone No.
Date of Birth	Place of Birth
Driver's License No.	State Issued
Mother's Maiden Name	Employer
Are you a United States Citizen? Yes No	Are you subject to any backup witholding tax? Yes No
Initial Deposit
All deposit accounts require an initial deposit. The initial deposit amount required can be found on the Deposit Products page.
Choose one:
Transfer $ from account #
Check enclosed
Membership Elegibility
Federal Employee Agency	Zip Code
Select Employee Group SEG Name	Family Member Account Number
Joint Account Applicant Information
First Name, M.I.	Last Name
Date of Birth	Social Security No.
Driver's License No.	State Issued
Beneficiaries
Do you want one or more beneficiaries? Yes No
If so, please enter Full Name, Social Security No. and Address for each person.
Full Name	Social Security No.
Street Address	City
State	Zip Code

Full Name	Social Security No.
Street Address	City
State	Zip Code
Overdraft Protection
Do you want overdraft protection? Yes No
If so, which overdraft resources do you wish to use?
Savings	MMA
LOC	Visa
If so, for what accounts?
Classic Checking
Signature Checking
Premier Checking
Additional Information
Please enter any additional comments that you would like to include with this application.

Please be patient, this takes a moment.

If you are mailing this form, we will need a photocopy of a valid driver's license photo I.D. for the primary account holder and all joint account holders. You will receive a signature card or form to be signed by you and all joint account holders. If you are coming in person, please bring in two forms of identification. One being a valid driver’s license, military ID or state-issued ID; the other being a social security card, health card, credit card, government employee ID or a utility bill in your name. Don't forget: an initial deposit of $25* is required to open an account.

All new members or current members adding a checking account must pass ChexSystems. If we have received an opening deposit and you do not qualify, your deposit will be returned along with a letter of explanation.

*Please note: Accounts with balances below $100 may be charged a low- balance fee. However, the low-balance fee is not charged on accounts as follows: the first 90 days an account is open; for members under 18 or over 65, when the member has balances totaling at least $100 in all Credit Union accounts; or with an established line of credit, Visa card or home loan.

Any suit involving any dispute or matter arising under this Agreement may only be brought in the United States District Court of the Western District of Misouri or any Missouri State court having jurisdiction over the subject matter of the dispute or matter.

This Agreement shall be governed by and construed in accordance with the laws of the State of Missouri.