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NEW MEMBERSHIP ACCOUNT CARD MEMBER APPLICATION AND OWNERSHIP INFORMATION Member No: Member: Street: SSN×TIN: City×State×Zip: Driver's LIC. No: Home Phone: Work Phone: Date of Birth: Cell Phone:

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7. If possible, make a copy or save a digital copy of the filled-out form for your records. This can serve as proof of submission and help in case any issues arise later on.

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