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iration Date ID 3 Expiration Date Joint Account Holder K ChexSystems: Last Name First Name Middle Na
ications required to avoid backup withholding. 09/25/07 Account Holder Signature Date Joint Account Holder Signature Yes, I elect to accept the Check Imaging option and agree to pay the associated service charge. If Joint Account Holder requests an MCU ATM/Check Card, check this box. Manhattan Branch Da
19 ID 1 Expiration Date 06/30/20 Joint Account Holder Check if address same as Primary Verification I
tification required to avoid backup withholding. Accou tld&r•Signa 0915+16 Date Joint Account Holder Signature Date Yes, I elect to accept the Check Imaging option and agree to pay the associated service charge. If Joint Account Holder requests an MCU ATM1Check Card, check this box. Brooklyn Branch AUS
Description ID 3 Expiration Date Joint Account Holder _ jChexSystems Last Name First Name Middle Na
red to avoid backup withholding. rg liiV)(49 Acme er A ignaturg 01/21/09 Date Joint Account Holder Signature Date Yes, I elect to accept the Check Imaging option and agree to pay the associated service charge. If Joint Account Holder requests an MCU ATM/Check Card, check this box. Sponsor Account Numb
Description ID 2 Expiration Date Joint Account Holder Verification Issued By: Gender: Female .Male
than the certification required to avoid backup withholding. Accd 09/23/16 Date Joint Account Holder Signature Date Yes, I elect to accept the Check Imaging option and agree to pay the associated service charge. If Joint Account Holder requests an MCU ATMIChedc Card, check this box. Coop City Branch KH
Description ID 2 Expiration Date Joint Account Holder Check if address same as Primary Verification I
other than the certification required to avoid backup withholding. 09,2316 Date Joint Account Holder Signature Date Yes, I elect to accept the Check Imaging option and agree to pay the associated service charge. If Joint Account Holder requests an MCU ATM/Chedc Card, check this box. Coop City Branch KH
119 ID 1 Expiration Date 0610120 Joint Account Holder Check if address same as Primary L Verificatio
other than the certification required to avoid backup withholding. 08:1516 Date Joint Account Holder Signature Date Yes, I elect to accept the Check Imaging option and agree to pay the associated service charge. If Joint Account Holder requests an MCU ATMIChedc Card, check this box. Brooklyn Branch Spo
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George W. Bush
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PERSONBROOKLYN NY
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the Internal Revenue Service
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the United States Government
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LOCATIONthe Municipal Credit Union
ORGANIZATIONTone Teller
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