Membership Form

Name(Required)

Prefix First Last

Address(Required)

Address Line 1 Address Line 2 City/Town County Postcode

Home Tel(Required)

Mobile Tel(Required)

Email(Required)

Enter Email Confirm Email

Date of Birth

Gender(Required)

Who owns the home where you live?(Required)

If Housing Association, which one:

What is your household make up?

Relationship Status(Required)

Children(Required)

ACCOUNT PASSWORD: Enabling telephone enquiries(Required)

To comply with Anti-Money Laundering Regulations, ALL potential Beacon Savings & Loans members are required to prove their identity and residency (ID). An account will only be opened once a person’s ID has been checked, confirmed and recorded. We will use digital checks to complete this. You may be asked to upload additional ID to complete this.

Membership(Required)

Membership with Beacon Savings & Loans costs £2.00. This will be taken with your first payment. Once you have paid this and have at least £1.00 in your shares (savings) you will be a full member of your credit union, Beacon Savings & Loans Check box to acknowledge

I Agree

BEACON SAVINGS & LOANS PRIVACY NOTICE

Beacon Savings & Loans is committed to protecting its Members’ privacy.

This application form must be completed IN FULL - The information requested is mandatory for Beacon to meet its legal obligations and to enable the Credit Union to carry out its contract with you. If you are not able to provide us with this information, we may not be able to open an account for you. If we request further information about you which is not required for the reasons given above we will ask you for your consent.

DIRECT MARKETING CONSENT(Required)

(New regulations as of 25th May 2018) Maintaining our relationship with you including marketing and market research Indicate here if you would like to receive direct marketing from Beacon. This will include any promotional information about Beacon products; services and any ongoing campaigns. Please Note: this is not a condition of Membership and under the General Data Protection Regulations (GDPR) you are able to withdraw your consent at any time simply by completing a Beacon.
I WOULD like to be INCLUDED in any Direct Marketing by Beacon:

DATA PROTECTION NOTICE

Beacon Savings & Loans will process your data in accordance with your rights under the Data Protection Act 2018. Your information may be processed by this Credit Union in any form and on any database used by us for the following purposes:

To consider any applications made by you,
To undertake statistical analysis, financial risk assessment, money laundering checks, compliance and regulatory reporting, fraud prevention and debt tracing.

The provision of false information is fraud and Beacon Savings & Loans may take action if a Member is found to have deliberately provided false or misleading information on their application. This could entail notifying the appropriate regulators and/or authorities, including police involvement. Under the new General Data Protection Regulations (GDPR) your Nominee now has the right to be informed and give permission for Beacon to hold any of their personal data (name, address and telephone number). However, if your Nominee is a Member of Beacon we already have their permisssion to do so. Please Note: It is your responsibility to keep your Nominee details up to date.

A Nominee form is to be completed and returned (not required if Nominee is a Member of Beacon) with your application for Membership. Please Note: providing a Nominee is not a requirement to open an account with Beacon, however in the event of your untimely death, if there is no Nominee and we are unaware of your next of kin any insurance payment or surplus shares may be paid to the UK Government.

ENHANCED DUE DILIGENCE AND POLITICALLY EXPOSED PERSONS (PEPs)

Definition: ‘A Politically Exposed Person/s (PEPs) are individuals whose prominent position in public life may make them vulnerable to corruption. The definition extends to immediate family Members and known close associates’.

To be compliant with the 4th Money Laundering Directive & financial crime prevention, introduced in 2017, Beacon is required to screen for domestic PEPs as part of our annual risk assessment, this includes using a 3rd party Commercial Screening Service. Any Member whom is identified as an enhanced risk by such a search will be recorded as part of the Beacon's anti money laundering (AML) risk assessment.

PLEASE BE AWARE WHEN COMPLETING THIS MEMBER APPLICATION FORM

The provision of false information is fraud and Beacon Savings & Loans may take action if a member is found to have deliberately provided false or misleading information on their Membership application. This could involve notifying the appropriate authorities.

IMPORTANT INFORMATION IN THE EVENT OF YOUR DEATH

In the event of your untimely death, Beacon offers Members free life cover with saving benefits and loan protection (age limitations & pre-existing conditions may apply).

Please read the information below carefully and then provide the details of a Nominee (nominated person) who you would like to benefit from this insurance. It is advisable to provide a substitute Nominee who we can contact in the event of your first Nominee’s untimely death.

Please Note: In the event a Nominee and substitute Nominee predeceasing you (the Member) Halton Credit Union shall pay any monies due to the Member’s Estate.

I, the person named on this application form, give permission and authorise the person/s named below to sign a consent form in order to release my medical records in the event of my death.

I understand that the information obtained by this Authorisation will be used to determine eligibility for benefits under the Members Life Cover Insurance Policy held by Beacon.
I understand that any nominated person making a claim in the event of my death must get their identity endorsed by a solicitor.
I understand that information WILL NOT be released to any person or organisation except to the appropriate insurance company or those acting on their behalf in connection with this claim.
I understand that I may request a copy of this Authorisation at any time and confirm that this authorisation shall be valid for the duration of my Membership with Beacon or until such time that I change the aforementioned nominated person.
I understand that a new form must be completed to change my nominated person (this could be due to a change in circumstance or in the event of their death). The new form must be signed and witnessed by a representative of Beacon who will then update my account details accordingly.

Please Note: if any of your Nominees are a Member of Beacon we already have their permission to hold data on them, therefore, the additional consent form is not required.

MY NOMINEE DETAILS: (please note this person must be over 18 years of age)(Required)

First Last

Address(Required)

Address Line 1 Address Line 2 City County Postcode

Contact Tel(Required)

Contact Email

Relationship to you(Required)

HCU M/ship No: (if applicable)

MY SUBSTITUTE NOMINEE DETAILS: (please note this person must be over 18 years of age)

First Last

Address

Address Line 1 Address Line 2 City County Postcode

Contact Tel

Contact Email

Relationship to you

HCU M/ship No: (if applicable)

EMPLOYMENT DETAILS(Required)

Name of Employer

Address

Address Line 1 Address Line 2 City County ZIP / Postal Code

Contact Tel No

Time employed

TAX RESIDENCY SELF-CERTIFICATION SECTION

Tax regulations require the collection of certain information about each account holder’s tax residency and citizenship status. This section is designed to capture the citizenship and residence for tax purposes of the person entitled to the income and assets associated with this account. Please ensure you provide the information to the best of your knowledge. Be advised that in certain circumstances we may be required to share this information with the relevant tax authorities. If you are a resident of the United States of America (USA) or a USA citizen, for tax purposes you are also required to provide a completed, signed and dated IRS Form W-9 as stated in the Internal Revenue Services (“IRS”) Regulations.

City/Town & Country of Birth

For the purposes of taxation, I am a resident or citizen in the following countries and my Tax Identification Number (TIN) or equivalent are detailed below: Please Note: You DO NOT have to pay tax in order to have tax residency - if you claim benefits in the UK, you are a UK resident for tax purposes.

Country

Country TIN

Please tick box if unavailable

Country

Country TIN

Please tick box if unavailable

I authorise Beacon Savings & Loans (Beacon) to provide a copy of this form directly or indirectly, to any relevant tax authorities or any party authorised to audit or conduct a similar control of the recipient for Tax Purposes, and to disclose to such tax authorities any additional information in their possession that is relevant to my qualification for any benefits claimed on the basis of this declaration.
I acknowledge and agree that any such information may be passed to any relevant bodies and those bodies may provide information regarding income or benefits to the country or countries of which I am resident for tax purposes.
I authorise Beacon to provide a copy of this form and information regarding income paid or credited to or for the benefit of the accounts set out in this form to any relevant parties.
I certify that I am the beneficial owner of all income to which this form relates and declare that all statements made in this Declaration are, to the best of my knowledge and belief, correct and complete.
I agree to submit a new form within 30 days of any changes.

BANK ACCOUNT & NATIONAL INSURANCE

Beacon Savings & Loans will be required to request both your bank account details and national insurance details. If you would prefer for us to store them now for future use, please complete the boxes below. I would like Beacon to store my details

Bank sortcode

Bank account

National Insurance

MEMBER DECLARATIONS:

Please read the following declarations and sign below to state that you are in agreement

I have read and understand all the information on this application form;
I confirm that I was given the opportunity to opt in or out of direct marketing by Beacon Savings & Loans on this Membership application form. This includes any promotional information about a product/s, service views, or campaigns. I am fully aware that this is not a condition of Membership and if opted in I am able to withdraw my consent at any time under the General Data Protection Regulations (GDPR), simply by completing a Beacon Savings & Loans Direct Marketing Withdrawal Form;
I confirm that I have chosen my Nominee and Substitute Nominee of my own free will and have not been influenced in any way. My Nominees have been informed and given their consent for Beacon to hold some of their personal data (name, address and telephone number), until such time that I change my Nominee or meet my untimely death. I am also aware that it is my responsibility to keep my Nominee details up to date.This information is detailed on a Beacon Nomination form which is retained by the Credit Union until my death;
I confirm that I have been given the detachable information sheet detailing the Financial Services Compensation Scheme (FSCS), including details of reimbursement entitlement, exemptions and who to contact should the unlikely situation arise;
I was made aware that with regards to tax income: the first £1,000 of dividend (interest paid on your Beacon savings account) is tax free and because Beacon does not deduct tax at source therefore any dividend of more than £1,000 will need to be declared by yourself;
I am aware that my National Insurance Number is required if I apply for a loan from Beacon. I understand that if I default on future loan repayments this information may be passed to the Department for Works and Pensions for the consideration of deductions from benefits that I am, or may become entitled to;
I understand and am fully aware that my employment details may be used for the purpose of seeking reimbursement of any unpaid loan balance through the courts, by an Attachment Of Earnings;
All being said, I hereby apply for Membership of and agree to abide by the rules of Beacon Savings & Loans - I declare that the information provided by me on this application form is true and correct to the best of my knowledge and belief.

Member’s signature

To view our membership terms & conditions please click here.

Membership Form

Membership Form

BEACON SAVINGS & LOANS PRIVACY NOTICE

DATA PROTECTION NOTICE

ENHANCED DUE DILIGENCE AND POLITICALLY EXPOSED PERSONS (PEPs)

PLEASE BE AWARE WHEN COMPLETING THIS MEMBER APPLICATION FORM

IMPORTANT INFORMATION IN THE EVENT OF YOUR DEATH

I, the person named on this application form, give permission and authorise the person/s named below to sign a consent form in order to release my medical records in the event of my death.

OFFICER OF BEACON SAVINGS & LOANS TO COMPLETE THE FOLLOWING INFORMATION

POLITICALLY EXPOSED PERSON OR PEP

PROMINENT PUBLIC FUNCTION

MEMBER DECLARATIONS:

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