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NCUA Chartering and Field of Membership Forms
Users can electronically fill in, save, and change their replies on the below versions
of the following NCUA Chartering and Field of Membership Forms. All of these forms
are in Microsoft Word.
NCUA 4000 - Conversion of State Charter to
a Federal Charter – Federal Credit Union Investigation Report.
NCUA 4001 - Federal Credit Union Investigation
Report.
NCUA 4008 - Organization Certificate.
NCUA 4009 - Approval of Organization Certificate
and Certification of Insurance.
NCUA 4012 - Report of Official and Agreement
to Serve.
NCUA 4015 - Application for Field of Membership
Amendment.
NCUA 4015-EZ - Application for Field of
Membership Amendment (use for all single common bond expansions and multiple common
bond expansions of less than 3,000).
NCUA 4221 - Notice of Meeting of Members to
Convert from a Federal to State Chartered Credit Union.
NCUA 4401 - Application to Convert from
a State to a Federal Credit Union.
NCUA 4505 - Affidavit - Proof of Results of
Membership Vote - Proposed Conversion From Federal Credit Union to State Credit
Union.
NCUA 4506 - Federal to State Conversion -
Ballot for Conversion Proposal.
NCUA 9500 - Application and Agreements for
Insurance of Accounts.
NCUA 9501- Certification of Resolutions.
NCUA 9600 - Information to be Provided in
Support of the Application of a State Chartered Credit Union for Insurance of Accounts.