TLC Home Banking/Phone Banking
Registration Form

TLC Home Banking and Phone Banking are free services, but you must register to use them. Your signature is required to authorize use. Please complete the form below. Then print the form, sign it, and mail or fax it to us at the number/address below. (If you have more than one account number that you would like a PIN for, please print and fill out this form in duplicate.) Please read about TLC Home Banking or about Phone Banking and the EFT Disclosure which contain important disclosure and security information. Your confirmation and access code will be emailed to the email address below.

Note: By filling out this registration form I understand that I will be registered to use both TLC Home Banking and Phone Banking.


Your Name
Your TLC Community Credit Union Account Number
Your Social Security Number - -
Your Daytime Phone Number ( ) -
Your Email Address

Note: Please make sure to include your COMPLETE email address, for example member@aol.com. If you do not have an email address, please write "none."

PLEASE READ THE FOLLOWING:
By signing below, I authorize TLC Community Credit Union to initiate the above services in conjunction with the above listed account number, and to send me access codes via email. I have read the disclosures regarding use of these systems and I agree to comply with all requirements stated therein. I agree to use reasonable care in protecting my account information including the use of my access codes. I understand that failure to comply with regulations outlined in the above-mentioned disclosures as well as any use of these systems other than their intended purpose will be grounds for termination of these services and could also result in additional prosecution and penalties as allowed by law.

X______________________________________________________ Date __________________
Member Signature - Required

X______________________________________________________ Date __________________
Joint Member Signature - Optional

Please print and mail this completed form to: TLC Community Credit Union, Attn: Call Center, P.O. Box 927, or drop the form off at any branch location. You may also sign up at any of our branch locations. Your confirmation and access code(s) will be emailed within 1 to 2 business days after we receive your registration form.

If you would like the ability to transfer funds from one TLC Community Credit Union account to another TLC Community Credit Union account AND you are the primary member or a joint member on BOTH accounts, please identify the account numbers below:

Transfer From Account No. ____________________ Transfer To Account No. _____________________

Transfer From Account No. ____________________ Transfer To Account No. _____________________

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