Name___________________________________________________________________________

Account Number__________________________________________________________________

Social Security Number____________________________________________________________

By signing this form I am stating that I realize that it is my responsibility to remember my password. If I should forget my password, I understand that the credit union does not have access to it and that I will have to contact the credit union and give proper identification to obtain a new one. I understand that I will not be able to obtain any password over the telephone. If I remember my old password and would just like to change it, I may do so on line at the sign in page.

The "Perfect Teller" program needs to be installed on your PC before you can use it. In order to install it, you need to download the SETUP program from United CU's Perfect Teller Update Page (www.perfect-teller.com/21365) and then click on that to start the installation. Follow the instructions for installing the Perfect Teller program on your PC. Once it is installed, you activate the program by clicking on the Start button, selecting Programs then selecting Perfect Teller. When you are using the program, make sure you have an active connection to the Internet. You may use the password that you assign. Simply designate any number or word or combination of both that you desire. Write in your "Perfect Teller" password below. You may use up to 32 characters digits. (Make your password something that will be easy for you to remember, but difficult for someone else to figure out.) Note: Passwords are case sensitive.

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