Credit Union

MEMBERSHIP NUMBER Finance Department, Unity House, 39 Chalton Street, London NW1 1JD RMT CREDIT UNION APPLICATION FORM – please complete your application along with the attached Direct Debit. Please use BLOCK CAPITALS and black ink. 1 PERSONAL DETAILS. Surname Address Forename(s) Home phone Mobile phone Postcode Email address Date of Birth National Insurance Number 2 Your Employment. Employer RMT Branch Job Description 3 Mr Mrs Ms Miss 4 Membership Status RMT TU Member Retired RMT TU Member 5 How much do you wish to save £ This is the amount you wish to save in ‘shareholdings’ monthly by Direct Debit (you must complete form below) 6 Normally your payments are made once a month (28th) to RMT Credit Union Ltd. 7 Next of Kin ..................................................................................... Address ..................................................................................... ..................................................................................... ..................................................................................... 8 I undertake to abide by the rules now in force or those that are adopted. Your signature Date Instruction to your Bank or Building Society to pay by Direct Debit Please fill in the whole form including official use box using a ball point pen and Send to: RMT Credit Union Ltd., 39 Charlton Street, London NW1 1JD Name and full postal address of your Bank or Building Society Originator’s Identification Number Reference Number FOR RMT CREDIT UNION LTD OFFICIAL USE ONLY This is not part of the the instruction to your Bank or Building Society. To: The Manager Bank/Building Society Address Postcode Signature(s) Date Name(s) of Account Holder(s) Bank/Building Society account number Branch Sort Code Instructions to your Bank or Building Society. Please pay RMT Credit Union Ltd Direct Debits for the account detailed in this instruction subject to the safeguards assured by the Direct Debit Guarantee. I understand that this instruction may remain with RMT Credit Union Ltd, if so, details will be passed electronically to my Bank/Building Society. Banks and Building Societies may not accept Direct Debit Instructions from some types of account This guarantee should be detached and retained by the Payer. The Direct Debit Guarantee G This guarantee is offered by all Banks and Building Societies that take part in the Direct Debit Scheme.The efficiency and security of the scheme is monitored and protected by your own Bank or Building Society. G If the amounts to be paid or the payment date changes, RMT Credit Union Ltd will notify you 10 working days in advance of your account being debited or as otherwise agreed G If an error is made by RMT Credit Union Ltd or your Bank or Building Society, you are guaranteed a full and immediate refund from your branch of the amount paid G You can cancel a Direct Debit at any time by writing to your Bank or Building Society. Please also send a copy of your letter to us. ✂ 9 7 4 2 8 1 RMT CREDIT UNION LTD.