Before filling out this form, please review the disclosure information.

Today's Date

Account Information
First Name	Last Name	Account Number

SSN	Phone	E-Mail Address

Current CD Account Name

Instructions for Share Certificate (CD) at Maturity

[] Rollover at Current Rate.

Note; No response at the time of Share Certificate maturity will automatically renew Share Certificate at current rate with existing terms.

[] Transfer to New Share Certificate - Select Term - 6 Months 12 Months 18 Months 24 Months

[] Do Not Renew Certificate and deposit funds to Share/Savings Account.

You may also print this form and fax to (402) - 399-0129, mail to Omaha Federal Credit Union, 3001 So. 82nd Ave., Omaha, Nebraska 68124 or stop by one of our four office locations.