Beaver Valley FCU TellerNet application

Beaver Valley Federal Credit Union

APPLICATION PROCEDURE

Please complete the application form as instructed. Sign and return to your branch or to the address listed below. You will receive a 24 Hour Teller-Phone transaction guide, which includes instructions for use of the service (if applicable). Your USER ID and your security code (PIN) will be emailed to you.

If you do not participate in e-Statements, there will be a $12 annual fee (waived for Value Checking and Visa CheckCard accounts).

Thank you for using BVFCU’s e-Services

Name of Primary Member
Account No.	Social Security No.
e-mail address (required for TellerNet/BillPayer Services)
Mother’s Maiden Name (for security verification)


Check here to sign up for TellerNet FREE with Visa Check Card, Value Checking, or e-Statements

Sign up for FREE BillPayer Services ($4.95 inactive monthly fee may apply)

Check here to enroll in Teller-Phone our FREE 24 hour audio response telephone system
OPT-OUT: I do not want to receive electronic statements ($12.00 ANNUAL FEE may apply)

RELATED ACCOUNT ACCESS List below the accounts you wish to access via both TellerNet and TellerPhone. Access will allow you to tranfer funds TO another account. You must be a joint-owner on all accounts that you request e-access:
Primary Member’s Name	Account No.
Primary Member’s Name	Account No.
Primary Member’s Name	Account No.
Primary Member’s Name	Account No.

Authorization

You desire to subscribe to the e-Services you checked and authorize Beaver Valley Federal Credit Union, and any third party acting on our behalf, to serve as your agent in processing payments to merchants specified by you and/or your joint-owner, and you authorize the credit union to post such payments and/or transfers to your designated accounts. You understand that Beaver Valley Federal Credit Union may not make certain payments and/or transfers if sufficient funds are not available in your designated accounts. If a fee is charged for the service you request, you also authorize the credit union to debit the appropriate account. The credit union will replace your mailed paper statements with electronic statements, unless you 'OPT-OUT' of this service. This authorization is in force until revoked by you or the credit union in writing and is subject to the terms and conditions as amended from time to time.

_____________________________________________________
Signature Date

Primary Member

Joint-Owner

Please Print Name

Return to:

BEAVER VALLEY FCU
e-SERVICES
601 – 37 TH STREET
BEAVER FALLS, PA 15010

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