Fixed Deposit Savings Application Form – Postal & Partners Co-Operative Credit Union

Fixed Deposit Savings Application Form:

Date of Application:

Account Number:

TRN:

SECTION A- MEMBER INFORMATION

Member Name:

Date of Birth:

Gender:

Home Address:

Mailing Address:

Contact Number:

Email Address:

Name of Designated Beneficiary:

Relation:

Beneficiary Contact Number:

Name of Trustee (if beneficiary is under the age of 18)

Trustee Contact Number:

Section B- Savings/ Investements Details

Amount (Initial Investment)

Proposed Monthly

Period of Investment:

60 days

90 days

180 days

360 days

Mode of Investment:

Roll Over at the end of the investment

Cease at the end of the investment

MEMBERS DECLARATION:

I confirm that the information given is true in all respects, accurate and complete, and that I have not withheld any information that might affect the Credit Union's decision. I agree that early cancellation (1-30 days) will attract an administrative fee of $1000.999 deducted from the amount invested. I also agree that if I cancel this investment within 31 days or more, the applicable interest rate to be paid will be 1.5% less than the initial interest rate.

I also indemnify the PPCCUL of any liability resultiin in my inability to contribute weekly/ fortnightly/ monthly to this savings plan.

Name ( Member)

Signature:

Date: