Authorization Request Form
 
To sign up for Virtual Branch® please complete, print, and sign this form. However, before further processing, please read the SECU Virtual Branch Disclosure which explains the use, capabilities,
and liabilities of the system. This disclosure provides answers to questions regarding the security
and privacy of our web site.
 
Important – Please Note
 
    ▪  You must be a member of SECU Federal Credit Union before applying for access to
        Virtual Branch®.
     ▪  All requests must be made in writing using this form or a facsimile.
     ▪  You may mail or deliver the original, signed copy to our office at 1780 Fowler,
        Richland, Washington 99352.  Faxes and email are not accepted.
     ▪  Your account will be activated within the 24 hour period following the business day
        in which we receive your request.
     ▪  Your account number is the three to six digit member number on your statement.
     ▪  Access to Virtual Branch® will be controlled by means of a password/PIN.
        This password may be any combination of numeric characters that you wish.  If you
        are already a user of our STAT line, Virtual Branch® may be set up with
        the same four-digit PIN. Otherwise, your account will be set up with a temporary
        password.  Please change this password to one of your choosing as soon as possible.
 
        Access Number_______________                 Access Number_______________

        Access Number_______________                 Access Number_______________
 
I hereby authorize SECU Federal Credit Union to make my account information accessible via the internet.  I have read the account information disclosure and accept the applicable terms.
 
Signed Name:____________________________________________________________

Printed Name:____________________________________________________________

Email address:____________________________________________________________

Mother’s Maiden Name:___________________________
 
I HAVE READ THE ACCOUNT DISCLOSURE AND
   
 £  I AGREE
 £  I DO NOT AGREE