SmartCash VISA Check Card Application

Please fill out the form on your screen, print out and mail to the address listed below. The Credit Union requires an INK Signature for this application. We will not accept a faxed copy. This helps to reduce account fraud.

Please note

• Signatures MUST be notarized on applications mailed to the Credit Union

Baltimore County Employees Federal Credit Union
23 W. Susquehanna Avenue - Towson, MD 21204

The SmartCash VISA Check Card is a debit card that automatically deducts the money from your Credit Union checking account when you make a purchase or an ATM withdrawal.

The SmartCash VISA Check Card is only available to members who have a checking account with the Credit Union.

Member Name:
Current Mailing Address:
City:		State Maryland Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District Of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming
Zip+4:
Daytime Phone:	- -
Email:
Account Number:
Social Security Number:	- -
Joint Owner Name: (if applicable)
Please activate my SmartCash VISA Check Card.The acceptance or use of the VISA Check Card is subject to the terms and conditions of the Agreement and Disclosure Pamphlet which will be mailed under a separate cover.

Signature of Member (Applicant)	Date (MO.,DAY, YEAR)
X ___________________________________________________	___________________________
Signature of Joint Owner (if applicable)	Date (MO.,DAY, YEAR)
X ___________________________________________________	___________________________