ACCOUNT HOLDER NAME ACCOUNT NUMBER

MEMBER VERIFICATION PASSWORD SOCIAL SECURITY NUMBER DATE OF BIRTH

PRIMARY MAILING ADDRESS CITY STATE ZIP

APGFCU Membership Application

ELIGIBILITY CERTIFICATION

SIGNATURES AND CERTIFICATIONSBACKUP WITHHOLDING CERTIFICATION

Select ownership type: Individual Joint with survivorship Pay on Death Provision Custodial Trust: Separate Agreement Dated _________ Other ________________

OWNERSHIP OF ACCOUNT

By signing above, under the penalties of perjury, I certify (1) that the number shown on this form is my correct taxpayer identification number; (2) that I am not subject to backup withholding either because I have not been notified that I am subject to backup withholding as a result of a failure to report all interest or dividends, or the Internal Revenue Service has notified me that I am no longer subject to backup withholding, and (3) I am a U.S. person (including a U.S. resident alien). Certification instructions: You must cross out item 2 above if you have been notified by the IRS that you are currently subject to backup withholding because you have failed to report all interest and dividends on your tax return.

BY SIGNING ABOVE, I/We HEREBY MAKE APPLICATION FOR MEMBERSHIP IN THE ABERDEEN PROVING GROUND FEDERAL CREDIT UNION AND AGREE TO ABIDE BYTHE FEDERAL CREDIT UNION ACT, NCUA RULES AND REGULATIONS, LAWS OF THE STATE OF MARYLAND, WHERE APPLICABLE, AND THE CREDIT UNION BY-LAWSAND AMENDMENTS THEREOF AND SUBSCRIBE FOR AT LEAST ONE (1) SHARE. The undersigned acknowledge receipt of “All About Your Accounts” (hereinafter referred to as Agreement) and agrees to be bound by the terms and conditions of the same, which Agreement is incorporated by reference herein and made a part thereof. My/Our signature also constitutes a request for any identifying number and/or access device issued by the Credit Union in connection with such accounts. The Credit Union is authorized to obtain such financial information/credit bureau reports relating to me/us as it deems necessary in order to process my/our accounts/services. The Credit Union is hereby authorized to charge this account for any obligation owed by me/us, or any joint owners, if applicable, to the Credit Union. The undersigned also acknowledges receipt and agrees to be bound by all conditions applicable to each listed account and the following: ATM, Check Card, ABBY, and Checking Account which are incorporated by reference herein and made a part thereof. I am/We are affirming under penalties of perjury I am/we are eligible to join APGFCU as designated in the eligibility field shown above.

ELIGIBILITY PLACE OF EMPLOYMENT, WORSHIP, STUDY OR VOLUNTEER DUTY: FAMILY MEMBER NAME if eligible through family OFFICER

PRIMARY PHYSICAL ADDRESS if above is P.O. Box CITY STATE ZIP SIGNATURE Signature not requiredThe Internal Revenue Service does not require your consent to any provision of this document other than the certifications required to avoid backup withholding.

X (seal)

UNEXPIRED PHOTO GOV’T ID W/SIGNATURE # TYPE STATE EXPIRATION

EMAIL ADDRESS HOME PHONE WORK PHONE CELL PHONE

Today’s Date: __________________________

PAY ON DEATH PROVISION BENEFICIARYFULL LEGAL NAME SOCIAL SECURITY NUMBER FULL LEGAL NAME SOCIAL SECURITY NUMBER

MC-NMB-FM-012519

SOCIAL SECURITY NUMBER DATE OF BIRTH NAME SIGNATURE

X (seal)

PRIMARY MAILING ADDRESS CITY STATE ZIP OWNERSHIP TYPE Joint Custodial Trustee Administrator

PRIMARY PHYSICAL ADDRESS if above is P.O. Box CITY STATE ZIP PRIMARY PHONE

UNEXPIRED PHOTO GOV’T ID W/SIGNATURE # TYPE STATE EXPIRATION EMAIL ADDRESS

ADDITIONAL SIGNERS

SOCIAL SECURITY NUMBER DATE OF BIRTH NAME SIGNATURE

X (seal)

PRIMARY MAILING ADDRESS CITY STATE ZIP OWNERSHIP TYPE Joint Custodial Trustee Administrator

PRIMARY PHYSICAL ADDRESS if above is P.O. Box CITY STATE ZIP PRIMARY PHONE

UNEXPIRED PHOTO GOV’T ID W/SIGNATURE # TYPE STATE EXPIRATION EMAIL ADDRESS

SOCIAL SECURITY NUMBER DATE OF BIRTH NAME SIGNATURE

X (seal)

PRIMARY MAILING ADDRESS CITY STATE ZIP OWNERSHIP TYPE Joint Custodial Trustee Administrator

PRIMARY PHYSICAL ADDRESS if above is P.O. Box CITY STATE ZIP PRIMARY PHONE

UNEXPIRED PHOTO GOV’T ID W/SIGNATURE # TYPE STATE EXPIRATION EMAIL ADDRESS

REPLACEMENT MEMBERSHIP APPLICATION

Yes No Date of Replacement:REASON FOR REPLACEMENT: Remove Joint: Add Joint: Name Change: Other:

SERVICES

Member Protect Checking High Yield Checking Standard Checking ATM Card Regular Share (savings) Check Card eServices PIN Issued Other:

Account Holder Name: Account No: Date of Birth: Member Verification Password: Work Phone: Social Security No: Cell Phone: Email: Mailing Address: Photo ID No: ID State: ID Zip: Physical City: Physical State: Mailing City: Mailing State: Mailing Zip: ID Type: Box Signature: OffReplacement Membership: OffDate of Replacement: Box Add Joint: OffBox Remove Joint: OffBox Other: OffAdd Joint: Remove Joint: Name Change: Box Member Protect: OffBox Standard Checking: OffBox ATM Card: OffBox Check Card: OffBox Regular Shares: OffBox eServices PIN: OffBox Name Change: OffBox Other Service: OffOther: Eligibility: Physical Address: Eligibility Place: Eligibility Family Member: Physical Zip: Officer: Box High Yield Checking: OffBox Custodial: OffBox Trust: OffBox Other Account Ownership: OffOther Service: Other Account Ownership: Trust Dated: Home Phone: Box Pay on Death Provision: OffBox Individual Ownership: OffBox Joint Survivorship: OffTodays Date: Beneficiary2 Full Name: Beneficiary Full Name: Beneficiary SS: Beneficiary2 SS: Signer Owner Joint: OffSigner Owner Custodial: OffSigner Owner Trustee: OffSigner Owner Admin: OffSigner SS: Signer Date of Birth: Signer Name: Signer Mailing Address: Signer Physical Address: Signer Photo ID: Signer City: Signer Physical City: Signer ID Type: Signer State: Signer Physical State: Signer ID State: Signer Zip: Signer Physical Zip: Signer ID Expiration: Signer Phone: Signer email: Signer2 SS: Signer2 Date of Birth: Signer2 Name: Signer3 SS: Signer3 Date of Birth: Signer3 Name: Signer2 Mailing Address: Signer2 City: Signer2 State: Signer2 Zip: Signer3 Mailing Address: Signer3 City: Signer3 State: Signer3 Zip: Signer2 Owner Joint: OffSigner2 Owner Custodial: OffSigner2 Owner Trustee: OffSigner2 Owner Admin: OffSigner3 Owner Joint: OffSigner3 Owner Custodial: OffSigner3 Owner Trustee: OffSigner3 Owner Admin: OffSigner2 Physical Address: Signer2 Physical City: Signer2 Physical State: Signer2 Physical Zip: Signer2 Phone: Signer3 Physical Address: Signer3 Physical City: Signer3 Physical State: Signer3 Physical Zip: Signer3 Phone: Signer2 Photo ID: Signer2 ID Type: Signer2 ID State: Signer2 ID Expiration: Signer2 email: Signer3 Photo ID: Signer3 ID Type: Signer3 ID State: Signer3 ID Expiration: Signer3 email: SERVICES: SIGNATURE: if you have been notified by the IRS that you are currently subject to backup withholding because you have failed to report all interest and dividends on your tax return: SIGNATURE_2: seal: SIGNATURE_3: SIGNATURE_4: