• No monthly fee with HCU Checking

• Zero Liability for unauthorized purchases

• Easy tracking of your purchases on your monthly statement or view real-time balances online at www.hcu.coop

• Surcharge-free access to over 28,000 ATMs nationwide via the Co-op network

• Get cash back when you make a purchase at participating merchants with no extra trips to the ATM

A HCU Visa Debit Card gives you instant access to your HCU checking and savings account. You can make in-store purchases at your favorite retailer or with any merchant on-line that accepts Visa. You can also make transactions at ATMs everywhere. All this and many more great features:

Member Number

Day Time Phone

Mobile Phone

Your Name

Joint Owner’s Name

Address

Please read before signing:I (We) authorize the credit union to verify or obtain further information the credit union may deem necessary concerning my (our) credit history. If this application is approved and a debit card is issued, the undersigned applicant(s), by signing, using, or permitting another to use the debit card agree to be bound by the terms and conditions accompanying the debit card and all amendments. The undersigned hereby acknowledges that the signing, using, or permitting another to use the debit card represents an acknowledgement of the receipt of the debit card agreement and all amendments and further represents the acceptance of terms and conditions of the debit card agreement and all amendments.

XYour Signature

XJoint Owner’s Signature (will issue 2nd card with unique number)

Today’s date

Please print all information except your signature. The debit cards(s) will be ordered exactly as the name(s) appear below.

Office Use:

Approval Date: _________________________

Approved By: _________________________

Referred By: _________________________

HCU VISA® Debit Card applicationHCU

Debit Card

www.hcu.coop ● 620.669.0177 or 800.428.8472

Your savings federally insured to at least $250,000 and backed by the full faith and credit

of the United States Government

National Credit Union Administratrion, a U.S. Government Agency

Branches: Hutchinson, Haven, Newton, and Wichita 9/2014

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