Are you or the applicant you are applying for (children 17 yrs or younger), an existing member of PCU? Yes No This field is hidden when viewing the formReference NumberPCU Membership Number(Required)Personal DetailsSurname(Required)Middle NameFirst Name(Required)Current Residential Address(Required)Mobile Phone(Required)Home PhoneEmail(Required) Subscribe to email marketing from PCU Youth Academy Subscribe to email marketing from PCU Youth Academy Confirmation(Required) I, hereby confirm, to the best of my knowledge that the information provided is true and correct. CAPTCHA Δ 18-25 yrs Application 17yrs & under Application This field is hidden when viewing the formReference NumberMembership Application ALL ORIGINAL DOCUMENTS MUST BE SUBMITTED & VERIFIED IN SUPPORT OF YOUR APPLICATION Copy of 1 valid form of ID i.e. national id, passport or driver’s permit Recent pay slip or recent job letter showing; position, current earnings and length of tenure (not more than (3) three months old) Recent utility bill, lease or rental agreement in the name of the applicant (if these documents are not available in the applicant’s name, a letter from the owner confirming residence, accompanied by a copy of the owner’s id MUST be submitted) Self-employed applicants must submit; statement of income, BIR number and copy of V.A.T. certificate (where applicable) Member is eligible to join the CUNA Indemnity Plan upon acceptance Member is entitled to an International Prepaid MasterCard upon acceptance Members are eligible to join the PCU Group Medical Plan upon approval. **Special Criteria Applies Recommender of applicant shall not be a family member to the applicant Recommender of applicant shall not be the beneficiary of the applicant Upon approval, the following fees are applicable: $10.00 – Entrance Fee | $50– Group Life | $100- Share DepositsPersonal DetailsSurname(Required)Middle NameFirst Name(Required)Date of Birth(Required) MM slash DD slash YYYY Gender(Required) M F Marital Status(Required) Single Married National ID, Passport or Driver’s Permit(Required)Max. file size: 1 MB.One (1) valid form of identification(National ID, Passport or Driver’s Permit)Residency Status(Required) Foreign nationals or Non Residents Resident Second Form of ID(Required)Max. file size: 1 MB.Only for Foreign nationals or Non ResidentsCurrent Residential Address(Required)Mobile Phone(Required)Home PhoneEmail(Required) Employment DetailsEmployment Status(Required) Self Employed Employed Unemployed Retired Homemaker Student Other Supporting Documents(Required)Max. file size: 1 MB.Pay slip, job letter or certified bank statements (covering 3-6 months) or documents proving pension payments or financial supportIncome(Required) Less than $5,000 per month More than $5,000 per month Nature of Business(Required)Company/Sole Trader Registration(Required)Max. file size: 1 MB.Income & Expenditure Statement(Required)Max. file size: 1 MB.BIR or VAT Certificate(Required)Max. file size: 1 MB.Bank Statement(Required)Max. file size: 1 MB.Bank statement covering a 3-month period or audited accounts.Employer Name(Required)Employer Address(Required)Educational Institution(Required)Please ExplainUtility Bill, Copy of Valid Lease/Rental Agreement(Required)Max. file size: 1 MB.Authorization LetterMax. file size: 1 MB.Required only if proof of address is not in the name of the applicant.Copy of the ID of the person giving authorisation (if applicable)Max. file size: 1 MB.Banking DetailsDo you have a Bank Account?(Required) Yes No Institution Name(Required)Account Number(Required)Account Type Savings Chequing Branch(Required)Branch Transit # (Scotiabank Customers Only)Managing Your AccountPlease indicate if you would like to register for(Required) Online Banking Telephone Banking I authorise the Trinidad and Tobago Police Credit Union to obtain information on my credit history from Credit Bureaux, Credit Reporting Agencies and/or other Credit Providers for the purpose of prequalification for loans, account management, and promotions. I agree to indemnify Police Credit Union jointly and severally against all claims in damages or otherwise arising from such disclosure. * Yes No Nomination of BeneficiaryNominee 1Nominee 1 Name(Required)Address(Required)Relationship to Member(Required)Home PhoneMobile Phone(Required)Email(Required) Percentage102030405060708090100Nominee 2Nominee 2 NameAddressRelationship to MemberHome PhoneMobile PhoneEmail Percentage102030405060708090100Foreign Account Tax Compliance ActTrinidad & Tobago National?(Required) Yes No Do you have Dual Citizenship?(Required) Yes No Are you a US Resident?(Required) Yes No State your IRS Tax NumberOther (please state)Politically Exposed Persons Have you or any of your family served as a:A Senior Military Officer(Required) Yes No Director on a State Board(Required) Yes No Minister of Government(Required) Yes No A Member of the Judiciary(Required) Yes No A Senior Public Official(Required) Yes No If you answered yes to any of the above, please request a PEP Declaration Form.DeclarationFull Name(Required)I, (name given above), apply for membership in the Trinidad and Tobago Police Credit Union Co-operative Society Limited and affirm that the information given in this form is true and correct.I declare that this account is to be used for Savings Loans And all monies credited to my account are derived from(Required)I agree to abide by the existing Bye-Laws of the society and the laws of Trinidad and Tobago and acknowledge that I am not a Bona Fide member until this application is approved by the Board of Directors.(Required)Please sign with your mouse in the field above.Confirmation(Required) I, hereby confirm, to the best of my knowledge that the information provided is true and correct. Group Life Insurance EnrolmentApplicant's DetailsApplicant's Surname(Required)Applicant's First Name(Required)Date of Birth(Required) MM slash DD slash YYYY Sex(Required) M F Email(Required) Marital Status(Required) Single Married Policyholder Name: Trinidad And Tobago Police Credit Union Association Employer Credit Union Do you have any other form of insurance? Motor Fire Burglary Marine Life Medical Applicant's Occupation(Required)How are earnings payable? Hourly Weekly Monthly Annually Beneficiary DetailsBeneficiary's Surname(Required)Applicable to health/lifeBeneficiary's First Name(Required)Applicable to health/lifeBeneficiary's relationship to Applicant(Required)InsuranceAmount of Life InsuranceAmount of AD & D InsuranceHealth Insurance Yes No Employee Category Employee Only Employee & One Employee & Family CAPTCHA Δ This field is hidden when viewing the formReference NumberMembership Application ALL ORIGINAL DOCUMENTS MUST BE SUBMITTED & VERIFIED IN SUPPORT OF YOUR APPLICATION Youth Member’s Documents Copy of new birth certificate Copy of passport / national id (if available) Adult Opening/ Servicing the Account Documents 1 valid form of id card, passport and/or driver’s permit Recent pay slip or recent job letter showing; position, current earnings and length of tenure (not more than (3) three months old) Recent utility bill (if utility bill is not in applicant’s name, a letter from the owner & copy of owner’s id MUST be submitted) Self employed applicants must submit: statement of income, BIR number and copy of V.A.T. certificate (where applicable) Recommender of applicant shall not be a family member to the applicant Recommender of applicant shall not be the beneficiary of the applicant Upon approval, the following fees are applicable: $10.00 – Entrance Fee | $50– Group Life | $50- Share DepositsPersonal Details (Child)Surname(Required)Middle NameFirst Name(Required)Date of Birth(Required) MM slash DD slash YYYY Gender(Required) M F Birth Certificate PIN(Required)Current Residential Address(Required)School Attending(Required)Class/Form(Required)Mobile Phone(Required)Home PhoneEmail(Required) Child’s birth certificateMax. file size: 1 MB.Child’s Passport or IDMax. file size: 1 MB.Parent, Guardian or Relative DetailsSurname(Required)Middle NameFirst Name(Required)Phone(Required)Relationship to Applicant Parent Guardian Relative Other ID/DP/PP(Required)National ID, Passport or Driver’s Permit(Required)Max. file size: 1 MB.One (1) valid form of identification(National ID, Passport or Driver’s Permit)Residency Status(Required) Foreign nationals or Non Residents Resident Second Form of ID(Required)Max. file size: 1 MB.Only for Foreign nationals or Non ResidentsEmployment DetailsEmployment Status(Required) Self Employed Employed Unemployed Retired Homemaker Student Other Work Phone(Required)Supporting Documents(Required)Max. file size: 1 MB.Pay slip, job letter or certified bank statements (covering 3-6 months) or documents proving pension payments or financial supportNature of Business(Required)Company/Sole Trader Registration(Required)Max. file size: 1 MB.Income & Expenditure Statement(Required)Max. file size: 1 MB.BIR or VAT Certificate(Required)Max. file size: 1 MB.Bank Statement(Required)Max. file size: 1 MB.Bank statement covering a 3-month period or audited accounts.Occupation(Required)Employer Name(Required)Employer Address(Required)Educational Institution(Required)Please ExplainUtility Bill, Copy of Valid Lease/Rental Agreement(Required)Max. file size: 1 MB.Authorization LetterMax. file size: 1 MB.Required only if proof of address is not in the name of the applicant.Copy of the ID of the person giving authorisation (if applicable)Max. file size: 1 MB.Nomination of BeneficiaryNominee 1Nominee 1 Name(Required)Address(Required)Relationship to Member(Required)Home PhoneMobile Phone(Required)Email(Required) Percentage102030405060708090100Nominee 2Nominee 2 NameAddressRelationship to MemberHome PhoneMobile PhoneEmail Percentage102030405060708090100Foreign Account Tax Compliance ActTrinidad & Tobago National?(Required) Yes No Do you have Dual Citizenship?(Required) Yes No Are you a US Resident?(Required) Yes No State your IRS Tax NumberOther (please state)Politically Exposed Persons Have you or any of your family served as a:A Senior Military Officer(Required) Yes No Director on a State Board(Required) Yes No Minister of Government(Required) Yes No A Member of the Judiciary(Required) Yes No A Senior Public Official(Required) Yes No If you answered yes to any of the above, please request a PEP Declaration Form.DeclarationFull Name(Required)I, (name given above), in this application for my child's/ward's/relative's membership into the Trinidad and Tobago Police Credit Union, hereby declare that the account is to be used for savings.All monies credited to his/her Credit Union account are derived from:(Required)I agree to abide by the existing Bye-Laws of the society and the laws of Trinidad and Tobago and acknowledge that I am not a Bona Fide member until this application is approved by the Board of Directors.(Required)Please sign with your mouse in the field above.Confirmation(Required) I, hereby confirm, to the best of my knowledge that the information provided is true and correct. Group Life Insurance EnrolmentApplicant's Details (Child)Applicant's Surname(Required)Applicant's First Name(Required)Date of Birth(Required) MM slash DD slash YYYY Sex(Required) M F Email(Required) Marital Status(Required) Single Married Policyholder Name: Trinidad And Tobago Police Credit Union Association Employer Credit Union Do you have any other form of insurance? Motor Fire Burglary Marine Life Medical Applicant's Occupation(Required)How are earnings payable? Hourly Weekly Monthly Annually Beneficiary DetailsBeneficiary's Surname(Required)Applicable to health/lifeBeneficiary's First Name(Required)Applicable to health/lifeBeneficiary's relationship to Applicant(Required)InsuranceAmount of Life InsuranceAmount of AD & D InsuranceHealth Insurance Yes No Employee Category Employee Only Employee & One Employee & Family CAPTCHA Δ
