Secure Home Banking Sign Up Form
83 Merrimack Street, Lowell, MA 01852
Phone: (978) 328-5100 • Fax: (978) 458-8933

You must currently be a Mills42 Federal Credit Union member to complete this form!
The information requested below is for the primary member on the account.
All Fields Are Required
Member Account Number:
Email Address:
First Name:
Middle Name or Initial:
Last Name:
Street Address:
City:
State:
Zip:
Home Phone #:
Cell Phone #:
Work Phone #: Ext:
Last 4 of Social Security #:
Birthdate (MM/DD/YY):

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