Joint Owner Removal Form

OWNER / ACCESS REMOVAL REQUEST
VIRGINIA CREDIT UNION, INC. (VACU)
POB 90010, Richmond, VA 23225-9010
804-323-6800 or toll free 1-800-285-6609
READ THIS IMPORTANT INFORMATION BEFORE SIGNING
Individuals such as members, joint owners, trustees, co-trustees and authorized signers, may be removed as owners or
authorized signers on accounts, provided that at least one member acknowledges and remains an owner of such account, and
such account is at a positive or zero balance. Removal of any Owner / Authorized Signer does not remove such person of any
current liabilities such as, but not limited to: (1) any transaction initiated prior to VACU accepting and processing this removal
request; or (2) any obligation as guarantor / joint applicant for any VACU debt such as credit card, mortgage, loan, or line of
credit. A joint owner is not removed until VACU receives, accepts and processes: (1) a revised Account Signature Card;
and (2) a completed Joint Owner Removal form. Upon removal, the revised Account Signature Card amends all prior
versions of such Card as it relates to the ownership of the specific account(s) identified below. Ownership for any
account not listed will not be changed. Signatures of the person being removed, along with at least one member’s signature
(or member’s authorized signer) are required and must be notarized unless witnessed and documented in the presence of a
VACU employee. If you choose, a different Notary can be used for each person’s signature. Once signed and your signature has
been Notarized, it is recommended that you maintain a copy of this document as proof of your removal authorization from the
account(s) specified.
LIST EVERY ACCOUNT NUMBER(S) APPLICABLE TO THIS SPECIFIC REQUEST.
IF AN ACCOUNT NUMBER IS NOT LISTED, THAT ACCOUNT WILL NOT BE CHANGED OR MODIFIED.
Account #: _____________________________ Type:
Savings Checking Premium MM Savings Certificate
Account #: _____________________________ Type:
Savings Checking Premium MM Savings Certificate
Account #: _____________________________ Type:
Savings Checking Premium MM Savings Certificate
Account #: _____________________________ Type:
Savings Checking Premium MM Savings Certificate
Account #: _____________________________ Type:
Savings Checking Premium MM Savings Certificate
Account #: _____________________________ Type:
Savings Checking Premium MM Savings Certificate
Account #: _____________________________ Type:
Savings Checking Premium MM Savings Certificate
Savings Checking Premium MM Savings Certificate
Account #: _____________________________ Type:
REMOVAL CERTIFICATION
(This section is for person being removed)
MEMBER CERTIFICATION
(This section is for remaining member only)
By signing below, you agree to all applicable terms and
conditions described in the section titled, “Read This Important
Information Before Signing.” You authorize VACU to remove
all your ownership / authorization access to the account
number(s) specified above.
By signing below, you agree to all applicable terms and
conditions described in the section titled, “Read This Important
Information Before Signing.” You authorize VACU to remove
all ownership / authorization access of the person identified in
the Removal Certification section from the account number(s)
specified above.
_________________________________________________
_________________________________________________
Signature of person being removed
Member’s Signature (or signature of Member’s Authorized Signer)
Member/CIF# (VACU Use only)________________________
Member/CIF# (VACU Use only)________________________
City / County of _____________________________________
City / County of _____________________________________
State / Commonwealth of _____________________________
State / Commonwealth of _____________________________
The foregoing instrument was acknowledged before me this
The foregoing instrument was acknowledged before me this
_________ day of _______________________, 20______, by
_________ day of _______________________, 20______, by
________________________________________________
________________________________________________
(Print name of person seeking acknowledgment)
(Print name of person seeking acknowledgment)
_________________________________________________
_________________________________________________
Notary Public Name (print)
Notary Public Name (print)
_________________________________________________
_________________________________________________
Notary Public Signature
Notary Public Signature
My commission expires:______________________________
My commission expires:______________________________
VACU
USE
(Rev:041015)
Activity Date
Branch
Accepted By
Member ID
Other Owner ID