Non-Dividend Account Addendum Form

Please change my SEFCU share accounts to non-dividend bearing accounts. I understand that SEFCU normally pays dividends on share accounts, as reflected in account disclosures on, in the SEFCU Member Benefits Guide and in the SEFCU Business Benefits Guide and I am requesting that the credit union make an exception in this case.

I understand that under this arrangement my share accounts will not earn dividends and SEFCU will not be required to provide IRS information returns, including the 1099-INT.



Member Account Number_____________________________________________________


Member Name (print)________________________________________________________


Company Name________________________________________________________


Member Signature________________________________________________________


Form instructions:
Please print this form, complete, and send to your business banking officer at the address below.

SEFCU Commercial Services
469 State Street
Schenectady, NY 12305
518-831-2050 (option 2)