ORGANISATION MEMBERSHIP

ORGANISATION MEMBERSHIP APPLICATION

PLEASE PRINT

Account No: Date of Application: 2024/11/21

Name of Business/Organisation:

Address:

Office #:

Mobile #:

Fax #:

Type of Business:

Established::

Registration/Certificate #

E-mail:

Source of funds

How has your wealth been accumulated? (please note that we may request further confirmation)

Income from Employment

Investments & Savings

Property

Other
(please specify)

What is the source of your initial deposit? (please note that we may request further confirmation)

Income from Employment

Investments & Savings

Property

Other
(please specify)

Please provide a brief description of the reason and purpose for establishing this account:

________________________________________________________________________________________

Account Activity

Please indicate the anticipated total value of Deposits through the account monthly

Please indicate the anticipated total value of Withdrawals through the account monthly$

Proof of your identity

In order to comply with our regulatory requirements, please supply us with two of the following documents. These must bear your signature and your photograph.

A current valid Passport (mandatory)
A national Voter's Identification card
A Driver's Licence

The certified copy must clearly show the photograph, signature and expiry date.

A valid copy of the Certificate of Registration, letter requesting permission to open the account, or Certification of Incorporation.

In addition, we also require confirmation of your permanent residential address. This may be anyone of the following documents and should be an original and not more than 3 months old:

o A utility bill such as water, electricity, telephone or Cable and Wireless

o A recognized bank or credit card statement

Please note that non-bank cards such as store cards, mobile telephone statements or addresses that feature Care of are not acceptable as confirmation of your residential address.

Early Closure Fee (If account is closed under 1 year of opening) $100.00"

WE HEREBY MAKE APPLICATION FOR AN ACCOUNT WITH Community First Co-operative Credit Union AND AGREE TO CONFORM TO ITS RULES AND AMENDMENTS THEREOF. WE UNDERSTAND THAT EXCEPT IN THE CASE OF A CO-OPERATIVE WE CANNOT BORROW, PURCHASE SHARES OR VOTE AT AN ANNUAL GENERAL MEETING.

The following person(s) are signatories to this account [AT LEAST THREE (3) PERSONS]. Any two (2) person(s) can sign.

NAME	ADDRESS	PHONE (HOME)	MOBILE	SIGNATURE

Witness to Signatories Witness to Signatories

This application was approved and entered in the Members' Register on:______________

----------------------------------- -----------------------------------
President Secretary

Herewith please find the sum of being as follows:

Deposits:

Entrance Fee:

Pass Book:

TOTAL: