Payroll Application

LONDON Rotherhithe SE28 SE1 SE16 SE10 Woolwich SE2 SE11 SE17 SE8 SE7 SE18 Greenwich OTHER DETAILS SE15 SE14 SE5 SE3SE 3 Camberwell Peckham A credit union for the working community of London SE Postcode areas Blackheath East DulwichSE4SE 4 Brixton SE13SE 13 SE24 SE22 Hither Green Dulwichh Village SE12SE 12 SE9SE 9 Forest Hill SE21 Catford Are you interested in Family Membership? Yes □ No □ SE23SE 23 SE6SE 6

SE27 SE26SE 26

Crystal Palace SE19 CRO NSAVERS SE20 CREDIT UNION LTD SE25 How did you hear about us? □ Employer □Church/ School □ Internet/ website □ Leaflet/ Flyers □ Other: ...... Where did you acquire this application form? …………………………………………………………………………………………… ...... Improve your Financial Health!

ABOUT CROWNSAVERS

LONDON Rotherhithe SE28 SE1 SE16 SE10 Woolwich SE2 SE11 SE17 SE8 SE7 International Tax Regulations SE18 Greenwich SE15 SE14 SE5 SE3SE 3 As required by the Common Reporting Camberwell Peckham A credit union for the working community of London SE Postcode areas Blackheath East DulwichSE4SE 4 Standard (CRS) we may be obligated to share Brixton SE13SE 13 SE24 SE22 Hither Green Dulwichh Village SE12SE 12 SE9SE 9 Forest Hill vinformation on financial services accounts to SE21 Catford SE23SE 23 SESE66 regulators for the purpose of tackling tax SE27 SE26SE 26

Crystal Palace SE19 CRO NSAVERS evasion. SE20 A Financial Services Compensation Scheme CREDIT UNION LTD SE25 Elegible deposits in Crownsavers Credit Union are protected by the Financial Serrvices Compensation Scheme. The limit of protection is £85,000 per depositor per credit union. Crownsavers Credit Union Privacy Notice We are comitted to protecting our members privacy and hold only the data necessary to enable us to provide services to you. We do not sell or provide member’s information to any Membership Application Form third party and the law requires us to hold member’s data for 7 years. Payroll

AssociationB of British Credit Unions Limited

Crownsavers Credit Union Ltd is authorised by the Prudential Regulation Authority and regulated Crownsavers Credit Union Ltd is authorised by the Prudential Regulation Authority and regulated by the Financial Conduct Authority and the Prudential Regulation Authority. by the Financial Conduct Authority and the Prudential Regulation Authority. Registered Firm Number 214295 Registered Firm Number 214295

LOND ON Rotherhi the SE28 LOND ON Rotherhi the SE28 SE1 SE1 SE16 SE10 Woolwi ch SE16 SE10 Woolwi ch SE2 SE2 SE11 SE11 SE17 SE8 SE7 SE17 SE8 SE7 SE18 BENEFICIARY OF YOUR CREDIT UNION ACCOUNT SE18 Greenwich Greenwich SE15 SE14 SE15 SE14 SE5 SE5 SE3SE 3 SE3SE 3 Camberwel l Peckham A credit union for the working community of London SE Postcode areas Camberwel l Peckham A credit union for the working community of London SE Postcode areas Blac kheath Blac kheath East Dulwi chSE4SE 4 East Dulwi chSE4SE 4 Brixt on SE13SE 13 Brixt on SE13SE 13 SE24 SE22 Hither Green SE24 SE22 Hither Green DulwiDulwichch VillagVillag e SE9SE 9 In the event of my death I nominate the undersigned as the person to whom shall be transferred such DulwiDulwichch VillagVillag e SE9SE 9 SE12SE 12 SE12SE 12 Forest Hil l Forest Hil l SE21 Catfor d SE21 Catfor d SE23SE 23 SE6SE 6 property in the Credit Union as may be mine at the time of my death whether in shares or otherwise. SE23SE 23 SESE66 SE27 SE26SE 26 SE27 SE26SE 26

Crys tal Palace Crys tal Palace SE19 CRO NSAVERS SE19 CRO NSAVERS SE20 CREDIT UNION LTD Nominee: Relationship of the nominee to the member: SE20 CREDIT UNION LTD SE25 SE25

Please complete in BLOCK CAPITALS and return to: Crownsavers Credit Union Address of Nominee: Post Code: 20 Catford Broadway, Catford, London, SE6 4SN. AUTHORISATION FOR PAYROLL DEDUCTION Before we can open the account for you need to see THREE original documents. To the Payroll Manager One two prove your identity (Current UK Passport, Current photo full driving licence), Your signature: Witness Name: (The witness cannot be the nominee) The other to prove your address (bill) Also your most recent payslip. Witness Signature: My employer is: Date: _ _ / _ _ / _ _ _ _ Employee Number: PERSONAL DETAILS NI Number: WORK DETAILS Forename: □ Mr □ Mrs □ Ms □ Others: Organisation: Department: Surname: Post Code: Surname: Middle Name: Forename: Payroll Number: Telephone: Title:

Home Address: Time at current Address: Department: Since: _ _ / _ _ / _ _ _ _ Telephone: MEMBERSHIP DECLARATION Post Code: Date of birth: Membership qualification: _ _ / _ _ / _ _ _ _ □ Family member □ Self Employed □ I hereby apply for membership of Crownsavers Credit Union and agree to abide by the rules of the Work Address: Post Code: □Working in SE Postcode □ Church Credit Union, and I declare that the information given by me on this form is true and correct to the Home Number: Mobile Number: best of my knowledge and belief. I give permission to receive updates, new and promotions offered by Crownsavers: □ Yes □ No Recommended minimum amount £27. One-off £10 membership fee will be deducted Home Email: Residential status: from your first payment. I acknowledge that I have received a copy of the Financial Services Compensation Scheme information □ Home Owner □ Renting □ Living with sheet. (must be ticked to open an account). □ Yes Please deduct £ parents/friends □ Temporary Accommodation General Data Protection Regulation (GDPR): In order to process your application, we will perform credit and Occupational Status: identity checks on you with one or more credit reference agencies (CRA,s). We will use this information to verify □ Full Time □ Part Time □ Student the accuracy of the data you have provided to us; and to manage your account(s). I have joined Lewisham Employees’ Credit Union and I have authorised the deduction of □ Retired □ Self Employed □ Other Name: Signature: the stated amount from my pay, at the end of each: Week Month Until further notice

If less than 3 years of residency, please provide us with your previous address Signature: Date: Previous Address: FOR OFFICE USE ONLY _ _ / _ _ / _ _ _ _ Post Code: OFFICE USE ONLY MEMBERSHIP No: Processed by: Date:_ _ / _ _ / _ _ _ _ Approved and passed by CU Date: Length of residency: Approved and passed by CU Date: _ _ / _ _ / _ _ _ _ Signature: _ _ / _ _ / _ _ _ _ Signature:

Crownsavers Credit Union Ltd is authorised by the Prudential Regulation Authority and regulated Crownsavers Credit Union Ltd is authorised by the Prudential Regulation Authority and regulated Crownsavers Credit Union Ltd is authorised by the Prudential Regulation Authority and regulated by the Financial Conduct Authority and the Prudential Regulation Authority. by the Financial Conduct Authority and the Prudential Regulation Authority. by the Financial Conduct Authority and the Prudential Regulation Authority. Registered Firm Number 214295 Registered Firm Number 214295 Registered Firm Number 214295 LOND ON Rotherhi the SE28 LOND ON Rotherhi the SE28 SE1 SE1 SE16 SE10 Woolwi ch SE16 SE10 Woolwi ch SE2 SE2 SE11 SE11 SE17 SE8 SE7 SE17 SE8 SE7 SE18 BENEFICIARY OF YOUR CREDIT UNION ACCOUNT SE18 Greenwich Greenwich SE15 SE14 SE15 SE14 SE5 SE5 SE3SE 3 SE3SE 3 Camberwel l Peckham A credit union for the working community of London SE Postcode areas Camberwel l Peckham A credit union for the working community of London SE Postcode areas Blac kheath Blac kheath East Dulwi chSE4SE 4 East Dulwi chSE4SE 4 Brixt on SE13SE 13 Brixt on SE13SE 13 SE24 SE22 Hither Green SE24 SE22 Hither Green DulwiDulwichch VillagVillag e SE9SE 9 In the event of my death I nominate the undersigned as the person to whom shall be transferred such DulwiDulwichch VillagVillag e SE9SE 9 SE12SE 12 SE12SE 12 Forest Hil l Forest Hil l SE21 Catfor d SE21 Catfor d SE23SE 23 SESE66 property in the Credit Union as may be mine at the time of my death whether in shares or otherwise. SE23SE 23 SE6SE 6 SE27 SE26SE 26 SE27 SE26SE 26

Crys tal Palace Crys tal Palace SE19 CRO NSAVERS SE19 CRO NSAVERS SE20 CREDIT UNION LTD Nominee: Relationship of the nominee to the member: SE20 CREDIT UNION LTD SE25 SE25

Please complete in BLOCK CAPITALS and return to: Crownsavers Credit Union Address of Nominee: Post Code: 20 Catford Broadway, Catford, London, SE6 4SN. AUTHORISATION FOR PAYROLL DEDUCTION Before we can open the account for you need to see THREE original documents. To the Payroll Manager One two prove your identity (Current UK Passport, Current photo full driving licence), Your signature: Witness Name: (The witness cannot be the nominee) The other to prove your address (bill) Also your most recent payslip. Witness Signature: My employer is: Date: _ _ / _ _ / _ _ _ _ Employee Number: PERSONAL DETAILS NI Number: WORK DETAILS Forename: □ Mr □ Mrs □ Ms □ Others: Organisation: Department: Surname: Post Code: Surname: Middle Name: Forename: Payroll Number: Telephone: Title:

Home Address: Time at current Address: Department: Since: _ _ / _ _ / _ _ _ _ Telephone: MEMBERSHIP DECLARATION Post Code: Date of birth: Membership qualification: _ _ / _ _ / _ _ _ _ □ Family member □ Self Employed □ I hereby apply for membership of Crownsavers Credit Union and agree to abide by the rules of the Work Address: Post Code: □Working in SE Postcode □ Church Credit Union, and I declare that the information given by me on this form is true and correct to the Home Number: Mobile Number: best of my knowledge and belief. I give permission to receive updates, new and promotions offered by Crownsavers: □ Yes □ No Recommended minimum amount £27. One-off £10 membership fee will be deducted Home Email: Residential status: from your first payment. I acknowledge that I have received a copy of the Financial Services Compensation Scheme information □ Home Owner □ Renting □ Living with sheet. (must be ticked to open an account). □ Yes Please deduct £ parents/friends □ Temporary Accommodation General Data Protection Regulation (GDPR): In order to process your application, we will perform credit and Occupational Status: identity checks on you with one or more credit reference agencies (CRA,s). We will use this information to verify □ Full Time □ Part Time □ Student the accuracy of the data you have provided to us; and to manage your account(s). I have joined Lewisham Employees’ Credit Union and I have authorised the deduction of □ Retired □ Self Employed □ Other Name: Signature: the stated amount from my pay, at the end of each: Week Month Until further notice

If less than 3 years of residency, please provide us with your previous address Signature: Date: Previous Address: FOR OFFICE USE ONLY _ _ / _ _ / _ _ _ _ Post Code: OFFICE USE ONLY MEMBERSHIP No: Processed by: Date:_ _ / _ _ / _ _ _ _ Approved and passed by CU Date: Length of residency: Approved and passed by CU Date: _ _ / _ _ / _ _ _ _ Signature: _ _ / _ _ / _ _ _ _ Signature:

Crownsavers Credit Union Ltd is authorised by the Prudential Regulation Authority and regulated Crownsavers Credit Union Ltd is authorised by the Prudential Regulation Authority and regulated Crownsavers Credit Union Ltd is authorised by the Prudential Regulation Authority and regulated by the Financial Conduct Authority and the Prudential Regulation Authority. by the Financial Conduct Authority and the Prudential Regulation Authority. by the Financial Conduct Authority and the Prudential Regulation Authority. Registered Firm Number 214295 Registered Firm Number 214295 Registered Firm Number 214295 LOND ON Rotherhi the SE28 LOND ON Rotherhi the SE28 SE1 SE1 SE16 SE10 Woolwi ch SE16 SE10 Woolwi ch SE2 SE2 SE11 SE11 SE17 SE8 SE7 SE17 SE8 SE7 SE18 BENEFICIARY OF YOUR CREDIT UNION ACCOUNT SE18 Greenwich Greenwich SE15 SE14 SE15 SE14 SE5 SE5 SE3SE 3 SE3SE 3 Camberwel l Peckham A credit union for the working community of London SE Postcode areas Camberwel l Peckham A credit union for the working community of London SE Postcode areas Blac kheath Blac kheath East Dulwi chSE4SE 4 East Dulwi chSE4SE 4 Brixt on SE13SE 13 Brixt on SE13SE 13 SE24 SE22 Hither Green SE24 SE22 Hither Green DulwiDulwichch VillagVillag e SE9SE 9 In the event of my death I nominate the undersigned as the person to whom shall be transferred such DulwiDulwichch VillagVillag e SE9SE 9 SE12SE 12 SE12SE 12 Forest Hil l Forest Hil l SE21 Catfor d SE21 Catfor d SE23SE 23 SESE66 property in the Credit Union as may be mine at the time of my death whether in shares or otherwise. SE23SE 23 SE6SE 6 SE27 SE26SE 26 SE27 SE26SE 26

Crys tal Palace Crys tal Palace SE19 CRO NSAVERS SE19 CRO NSAVERS SE20 CREDIT UNION LTD Nominee: Relationship of the nominee to the member: SE20 CREDIT UNION LTD SE25 SE25

Please complete in BLOCK CAPITALS and return to: Crownsavers Credit Union Address of Nominee: Post Code: 20 Catford Broadway, Catford, London, SE6 4SN. AUTHORISATION FOR PAYROLL DEDUCTION Before we can open the account for you need to see THREE original documents. To the Payroll Manager One two prove your identity (Current UK Passport, Current photo full driving licence), Your signature: Witness Name: (The witness cannot be the nominee) The other to prove your address (bill) Also your most recent payslip. Witness Signature: My employer is: Date: _ _ / _ _ / _ _ _ _ Employee Number: PERSONAL DETAILS NI Number: WORK DETAILS Forename: □ Mr □ Mrs □ Ms □ Others: Organisation: Department: Surname: Post Code: Surname: Middle Name: Forename: Payroll Number: Telephone: Title:

Home Address: Time at current Address: Department: Since: _ _ / _ _ / _ _ _ _ Telephone: MEMBERSHIP DECLARATION Post Code: Date of birth: Membership qualification: _ _ / _ _ / _ _ _ _ □ Family member □ Self Employed □ I hereby apply for membership of Crownsavers Credit Union and agree to abide by the rules of the Work Address: Post Code: □Working in SE Postcode □ Church Credit Union, and I declare that the information given by me on this form is true and correct to the Home Number: Mobile Number: best of my knowledge and belief. I give permission to receive updates, new and promotions offered by Crownsavers: □ Yes □ No Recommended minimum amount £27. One-off £10 membership fee will be deducted Home Email: Residential status: from your first payment. I acknowledge that I have received a copy of the Financial Services Compensation Scheme information □ Home Owner □ Renting □ Living with sheet. (must be ticked to open an account). □ Yes Please deduct £ parents/friends □ Temporary Accommodation General Data Protection Regulation (GDPR): In order to process your application, we will perform credit and Occupational Status: identity checks on you with one or more credit reference agencies (CRA,s). We will use this information to verify □ Full Time □ Part Time □ Student the accuracy of the data you have provided to us; and to manage your account(s). I have joined Lewisham Employees’ Credit Union and I have authorised the deduction of □ Retired □ Self Employed □ Other Name: Signature: the stated amount from my pay, at the end of each: Week Month Until further notice

If less than 3 years of residency, please provide us with your previous address Signature: Date: Previous Address: FOR OFFICE USE ONLY _ _ / _ _ / _ _ _ _ Post Code: OFFICE USE ONLY MEMBERSHIP No: Processed by: Date:_ _ / _ _ / _ _ _ _ Approved and passed by CU Date: Length of residency: Approved and passed by CU Date: _ _ / _ _ / _ _ _ _ Signature: _ _ / _ _ / _ _ _ _ Signature:

Crownsavers Credit Union Ltd is authorised by the Prudential Regulation Authority and regulated Crownsavers Credit Union Ltd is authorised by the Prudential Regulation Authority and regulated Crownsavers Credit Union Ltd is authorised by the Prudential Regulation Authority and regulated by the Financial Conduct Authority and the Prudential Regulation Authority. by the Financial Conduct Authority and the Prudential Regulation Authority. by the Financial Conduct Authority and the Prudential Regulation Authority. Registered Firm Number 214295 Registered Firm Number 214295 Registered Firm Number 214295 LONDON Rotherhithe SE28 SE1 SE16 SE10 Woolwich SE2 SE11 SE17 SE8 SE7 SE18 Greenwich OTHER DETAILS SE15 SE14 SE5 SE3SE 3 Camberwell Peckham A credit union for the working community of London SE Postcode areas Blackheath East DulwichSE4SE 4 Brixton SE13SE 13 SE24 SE22 Hither Green Dulwichh Village SE12SE 12 SE9SE 9 Forest Hill SE21 Catford Are you interested in Family Membership? Yes □ No □ SE23SE 23 SE6SE 6

SE27 SE26SE 26

Crystal Palace SE19 CRO NSAVERS SE20 CREDIT UNION LTD SE25 How did you hear about us? □ Employer □Church/ School □ Internet/ website □ Leaflet/ Flyers □ Other: ...... Where did you acquire this application form? …………………………………………………………………………………………… ...... Improve your Financial Health!

ABOUT CROWNSAVERS

LONDON Rotherhithe SE28 SE1 SE16 SE10 Woolwich SE2 SE11 SE17 SE8 SE7 International Tax Regulations SE18 Greenwich SE15 SE14 SE5 SE3SE 3 As required by the Common Reporting Camberwell Peckham A credit union for the working community of London SE Postcode areas Blackheath East DulwichSE4SE 4 Standard (CRS) we may be obligated to share Brixton SE13SE 13 SE24 SE22 Hither Green Dulwichh Village SE12SE 12 SE9SE 9 Forest Hill vinformation on financial services accounts to SE21 Catford SESE2323 SESE66 regulators for the purpose of tackling tax SE27 SE26SE 26

Crystal Palace SE19 CRO NSAVERS evasion. SE20 A Financial Services Compensation Scheme CREDIT UNION LTD SE25 Elegible deposits in Crownsavers Credit Union are protected by the Financial Serrvices Compensation Scheme. The limit of protection is £85,000 per depositor per credit union. Crownsavers Credit Union Privacy Notice We are comitted to protecting our members privacy and hold only the data necessary to enable us to provide services to you. We do not sell or provide member’s information to any Membership Application Form third party and the law requires us to hold member’s data for 7 years. Payroll

AssociationB of British Credit Unions Limited

Crownsavers Credit Union Ltd is authorised by the Prudential Regulation Authority and regulated Crownsavers Credit Union Ltd is authorised by the Prudential Regulation Authority and regulated by the Financial Conduct Authority and the Prudential Regulation Authority. by the Financial Conduct Authority and the Prudential Regulation Authority. Registered Firm Number 214295 Registered Firm Number 214295

LONDON Rotherhithe SE28 SE1 SE16 SE10 Woolwich SE2 SE11 SE17 SE8 SE7 SE18 Greenwich OTHER DETAILS SE15 SE14 SE5 SE3SE 3 Camberwell Peckham A credit union for the working community of London SE Postcode areas Blackheath East DulwichSE4SE 4 Brixton SE13SE 13 SE24 SE22 Hither Green Dulwichh Village SE12SE 12 SE9SE 9 Forest Hill SE21 Catford Are you interested in Family Membership? Yes □ No □ SE23SE 23 SE6SE 6

SE27 SE26SE 26

Crystal Palace SE19 CRO NSAVERS SE20 CREDIT UNION LTD SE25 How did you hear about us? □ Employer □Church/ School □ Internet/ website □ Leaflet/ Flyers □ Other: ...... Where did you acquire this application form? …………………………………………………………………………………………… ...... Improve your Financial Health!

ABOUT CROWNSAVERS

LONDON Rotherhithe SE28 SE1 SE16 SE10 Woolwich SE2 SE11 SE17 SE8 SE7 International Tax Regulations SE18 Greenwich SE15 SE14 SE5 SE3SE 3 As required by the Common Reporting Camberwell Peckham A credit union for the working community of London SE Postcode areas Blackheath East DulwichSE4SE 4 Standard (CRS) we may be obligated to share Brixton SE13SE 13 SE24 SE22 Hither Green Dulwichh Village SE12SE 12 SE9SE 9 Forest Hill vinformation on financial services accounts to SE21 Catford SESE2323 SESE66 regulators for the purpose of tackling tax SE27 SE26SE 26

Crystal Palace SE19 CRO NSAVERS evasion. SE20 A Financial Services Compensation Scheme CREDIT UNION LTD SE25 Elegible deposits in Crownsavers Credit Union are protected by the Financial Serrvices Compensation Scheme. The limit of protection is £85,000 per depositor per credit union. Crownsavers Credit Union Privacy Notice We are comitted to protecting our members privacy and hold only the data necessary to enable us to provide services to you. We do not sell or provide member’s information to any Membership Application Form third party and the law requires us to hold member’s data for 7 years. Payroll

AssociationB of British Credit Unions Limited

Crownsavers Credit Union Ltd is authorised by the Prudential Regulation Authority and regulated Crownsavers Credit Union Ltd is authorised by the Prudential Regulation Authority and regulated by the Financial Conduct Authority and the Prudential Regulation Authority. by the Financial Conduct Authority and the Prudential Regulation Authority. Registered Firm Number 214295 Registered Firm Number 214295