Skip to main content
United States flag An official website of the United States government
Official websites use .gov
A .gov website belongs to an official government organization in the United States.
Secure .gov websites use HTTPS
A lock () or https:// means you’ve safely connected to the .gov website. Share sensitive information only on official, secure websites.

Chartering, Field of Membership, and Conversion Resources

Chartering and Field of Membership Manual

Amendments to IRPS 08-2

IRPS 08-2 Service to Underserved Areas

IRPS 06-1, Organization and Operations of Federal Credit Unions Effective 6/22/2006

The NCUA Chartering and Field of Membership Forms

Users can print out and use the versions of the following NCUA Chartering and Field of Membership Forms that are listed below. All of these forms are in PDF.

Chartering Forms

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 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.

Field of Membership Forms

NCUA 4015 - Application for Field of Membership Amendment.

NCUA 4015-A - Application for Field of Membership Amendment (use for multiple common bond expansion for groups of 3,000 to 4,999 persons).

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).

Charter Conversion Forms

NCUA 4000 - Conversion of State Charter to a Federal Charter – Federal Credit Union Investigation Report.

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.

The NCUA is committed to providing an excellent user experience to all individuals, including persons with disabilities. If you require an accommodation to access information on or to use this website, contact us to request one. Please visit the NCUA's Accessibility Statement for additional information.

Last modified on