MEMBER VOTER VERIFICATION/IDENTIFICATION

By submitting this ballot I hereby certify that I am 16 years of age or older and a member in good standing of Bridge Credit Union, Inc.

For your vote to be counted:
1. Vote for three (3) candidates.
2. One ballot per member/account holder.
3. Voter verification/identification must be completed accurately.
4. Ballot must be received by March 23, 2016.

* 1. LAST FOUR DIGITS OF YOUR SOCIAL SECURITY NUMBER

* 2. YOUR NAME

* 3. YOUR BIRTH DATE

MM/DD/YYYY
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