Apply for a Share Certificate

SHARE CERTIFICATE APPLICATION
NJ GATEWAY FEDERAL CREDIT UNION
P.O. Box 420, Dayton, NJ 08810

Phone 732-329-3838 – Fax 732-329-8624

NJ Gateway Federal Credit Union offers the following certificate terms/ maturities:

3 months	$10,000 Minimum Deposit
5 months	$1,000 Minimum Deposit
6 months	$1,000 Minimum Deposit
1, 2, 3, 4 or 5-year	$1,000 Minimum Deposit

All deposits are insured by the National Credit Union Administration up to $250,000.00. Dividend rates are subject to change daily.
Current rates may be obtained by visiting our website at www.njgateway.org, via Call-24, or by calling a Member Service Representative at 732-329-3838.
Please complete all of the information below to establish a certificate account. Please return the form along with your deposit information either by mail or by fax. (See above info) A certificate will be issued and mailed to you upon establishment of the account.

Primary Applicants Name *

First

Middle

Last

Primary Applicants Street Address *

Primary Applicants: City, State, Zipcode *

Primary Applicants Account Number *

Primary Applicants Social Security Number *

Primary Applicants Home Phone *

Joint Applicants Name

First

Middle

Last

Joint Applicants Street Address

Joint Applicants: City/State/Zipcode

Joint Applicants Account Number

Joint Applicants Social Secirity Number

Joint Applicants Home Phone Number

I would like to purchase a certificate in the amount of ? Enter $ Amount *

What is the desired term of the certificate *

I would like the dividends to be paid in the following manner: *

Rollover (deposit back to the certificate account)
Deposited directly to my share savings account

I/We certify that the information on this application is true and accurate as of the date indicated by my/our signature below. I/We certify that I/we have provided correct tax payer identification number(s) and that I/we are not subject to backup withholding taxes as a result of a failure to report all interest or dividends. I/We certify that I/we have not been notified by the Internal Revenue Service or any other governmental agency of such. I/We have been provided a fee disclosure and rate schedule and I/we have read the information. By signing this application, I/we agree to abide by all terms and conditions described within the disclosures as well as provided on the certificate. Please type your names in the box below.

Website

Important Information About Opening Your Account at NJ Gateway Federal Credit Union (USA Patriot Act Sec. 326)

Federal Law requires that all financial institutions obtain, verify and record information that identifies each person who opens an account. Therefore, when you open an account, we will ask for your name, address, date of birth and other information that will enable us to identify you. We may also ask to see your government issued identification or other identifying documents. NJ Gateway FCU is committed to preserving and protecting the confidentiality of its members’ personal information. The credit union will maintain strong security controls to ensure that personal member information is protected from unauthorized use.

Apply for a Share Certificate

Important Information About Opening Your Account at NJ Gateway Federal Credit Union (USA Patriot Act Sec. 326)

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