Empire Federal Credit Union
Certificate Renewal Form

* Denotes required field

*Member name:

Member phone:

Member email:

*Member number:
* Account number:
 Maturity date (see notice):
Today's Date:
 

*1. What term would you like to renew your certificate at?

Terms: Fixed rate; $500 min.; dividends paid monthly

 
*2a. Do you want to transfer the balance of your maturing certificate to a current certificate?
2b. If you wish to transfer, please provide your Empire FCU certificate # of the account you're requesting the transfer to. Current certificate #:
 
*3a. What do you want to do with the accumulated dividends paid up to the maturity of your certificate?
3b. If you plan to transfer your accumulated dividends to another Empire FCU account, please state the account #. Account #:
 
*4a. What do you want to do with future dividends paid to your certificate?
4b. If you plan to transfer your dividends to another Empire FCU account, please state the account #. Account #:
 
*5a. Do you wish to redeem this certificate on maturity?
5b. If yes, then please tell us what you would like done with the funds.
5c. If you plan to transfer your funds to another Empire FCU account, please state the account #. Account #:
 
Special Instructions / Comments: