Forms and Applications


Download and complete the form you need, then submit it at any branch or mail it to the address listed on the form. Adobe Acrobat Reader1 is required to view and print certain forms.

Membership & Accounts

  1. Automatic Transfers Incoming & Outgoing (ACH)
  2. Change of Address
  3. Checking Account Reconciliation Worksheet
  4. Direct Deposit Authorization
  5. Member Handbook
  6. Member Handbook Money Market Select Account Addendum
  7. Member Handbook: Fee Schedule
  8. Member Handbook Discretionary Overdraft Services Terms Addendum
  9. Printable Membership Application
  10. Notification of Automatic Withdrawal Change
  11. Payroll Disbursement
  12. Federal Privacy Notice Form
  13. California Privacy Notice Form
  14. Sign up for Online Banking
  15. Request to Close Account
  16. Written Statement of Unauthorized Debit (ACH)
  17. Designation of Beneficiary
  18. CUSC Fee Schedule
  19. Patelco Open Ended Loan Agreement

Checking & Savings Accounts

  1. Free Checking
  2. Interest Checking
  3. Premier Interest Checking
  4. Tiered Savings
  5. Certificates
  6. Treasury Income Account
  7. Money Market Accounts
  8. IRAs
  9. ATM & Debit Card Application
  10. Affidavit of Forgery (Check Fraud)

Credit Card Forms & Applications

  1. Error in Billing – Dispute Form
  2. Fraud Claim Form
  3. Visa Gold Application
  4. Visa Platinum Application
  5. Visa Classic Application
  6. Student Visa Application
  7. Secured Visa Classic Application
  8. Printable Application
  9. Credit Card Disclosure

Health Savings Accounts

  1. HSA Online Application
  2. HSA Mail Application and Eligibility
  3. HSA Rollover Certification
  4. HSA Transfer Request
  5. HSA Withdrawal Authorization
  6. HSA Designation of Beneficiary
  7. HSA Contribution/Investment Form
  8. HSA Employer Contribution Form
  9. HSA Qualified Funding Form
  10. HSA Eligibility and Information

Personal Loans & Lines of Credit

  1. Signature Loan Application
  2. Savings Secured Loan Application
  3. Certificate Secured Loan Application
  4. Debt Consolidation Loan Application
  5. Computer Loan Application
  6. Pay Day Line of Credit Application
  7. Printable Application

Vehicle & Boat Loans

  1. Car & Truck Loan Application
  2. Motorcycle Loan Application
  3. Boat & RV Loan Application

Home & Home Equity Loans

  1. Home Loan & Home Equity Loan Application

Wire Transfers

  1. Domestic Outgoing Wire Request

Financial Preparation Kit

  1. Comprehensive Version
  2. Extra Sheets

IRA Contribution & Withdrawal

  1. Contribute to your Traditional IRA
  2. Contribute to your Roth IRA
  3. Make a withdrawal from your Traditional IRA
  4. Make a withdrawal from your Roth IRA

  1. Adobe Acrobat Reader is required. Get it free at adobe.com.