Adult Membership Application Portal

Step 1 of 12

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Update Due Date:

DD dash MM dash YYYY

Section A: Applicant Information

Title:*

Marital Status*

Sex*

Male

Female

Bond Information*

Enter Details of Bond:

Date of Birth*

DD dash MM dash YYYY

Full Name*

First Name Middle Name Surname

Maiden Name:

Alias:

Current Home Address*

Street Address Address Line 2 City/Town Parish/Milestones/Directions (If Applicable) Country

Nationality*

Enter Nationality

Is your Mailing Address the same as your Home Address?*

Yes

Mailing Address

Telephone Number (Cell)*

Telephone Number (Home)

Email*

Previous Home Address (Residence for less than 2-5 Years)*

Street Address Address Line 2 City/Town Parish/Milestones/Directions (If Applicable) Country

Residential Status*

Own

Rent

Other

State Residential Status:

Time at this Address (Years and Months)*

Number of Dependents*

Age of Dependents*

Section B: Applicant's Identification Information

ID Type*

Driver's License

Passport

National ID ( Voters Card/ Electoral Card/ Citizenship Card

Expiry Date*

DD dash MM dash YYYY

ID # Number*

Please Upload Front AND Back of ID

Upload ID FRONT*

Max. file size: 128 MB.

Upload ID FRONT

Upload ID BACK*

Max. file size: 128 MB.

Upload ID BACK

T.R.N.*

Upload TRN*

Max. file size: 128 MB.

Upload TRN

Section C: Employment Status & Other Information

Occupation*

The terms "businesswoman/businessman/manager" are not acceptable

Status*

State nature of business*

Name of Employer/Business/School*

Employee/School/Business Telephone Number*

Employer/Business/School Address

Street Address City Parish Country

Employed/Attending School Since:*

DD dash MM dash YYYY

Annual Salary/Income: ($)*

Source of Funds*

Expected Deposit Frequency:*

Annually

Monthly

Fortnightly

Weekly

Expected Deposit Amount: ($)*

Currency:

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Other Currency

Do you or your immediate family (parents, siblings, spouse, children, step children, in-laws) or close associates hold or has held any of the following positions

Head of State*

Yes

Head Government*

Yes

Minister of Government*

Yes

Member of the Judiciary*

Yes

Member of any house of Parliament*

Yes

Member of the police of or above the rank of Assistant Commissioner*

Yes

Official of any Political Party*

Yes

Military official above the rank of Captain*

Yes

Director or Chief Executive of any company in which the Government owns a controlling interest*

Yes

Senior management position in an international organization*

Yes

Permanent Secretary, Chief Technical Director or Chief Officer in charge of the operations of a ministry, department of Government, Executive Agency or statutory body as the case may be*

Yes

Please Give Details:

Do you have a spouse?

Section D: Spouse Information (if applicable)

Title:*

Sex*

Date of Birth*

DD dash MM dash YYYY

Enter Title:*

T.R.N.*

Full Name*

First Middle Last

Maiden Name

Nationality*

Current Home Address*

Street Address City Parish Country

Telephone Number: (Cell)*

Telephone Number: (Home)

Telephone Number: (Work)*

Telephone Number: (Fax)

Email*

Occupation*

The terms "businesswoman/businessman/manager" are not acceptable

Status*

State nature of business

Name of Employer/Business*

Employed Since*

DD dash MM dash YYYY

Address of Employer/Business*

Street Address City Parish Country

Is the spouse/parent/guardian expected to make lodgments to this account?*

Yes

If yes, what is the source of Funds

Actual Yearly Salary/Income:*

Section E How else can we contact you (Nearest Relative NOT living with you)

Title*

Sex*

Other Title

Name*

First Middle Last

Alias

Current Home Address*

Street Address City Parish Country

Nationality*

Enter Other Nationality

Relation to Applicant*

Name of Employer/Business/School*

Telephone Number (Cell)*

Telephone Number (Home)

Telephone Number (Work)

Email*

Occupation/Job Title*

The terms "businesswoman/businessman/manager" are not acceptable

Employer/Business/School Address

Street Address City Parish Country

Section F Verification

Select one of the following

Recent original utility bill in the name of the applicant

Recent correspondence (within the last three (3) months) in the applicant's name and bearing the same address (from the government, financial institution or place of employment)

Upload Proof of Address

Max. file size: 128 MB.

Upload Proof of Address

Section G Information for Reference(s). [References will be contacted]

Acceptable References Include

JDF Credit Union Board/Committee Member

Police Officer (Rank of Inspector or Higher)

JDF Credit Union Employee at supervisory level, employed for more than one (1) year

JDF Credit Union Member for more than two (2) years and in good standing

JP/Notary Public

Attorney-at-Law

Minister of Religion

Medical Doctor

Principal

Employer (HR Manager or Higher)

Manager of another Financial Institution where the applicant has an account in good standing (letter must state same)

Reference 1

Fill out the details below for the first Reference

Reference Type

Title

Other

Name

First Middle Last

Current Home Address*

Street Address City Parish Country

Nationality*

Other Nationality

How long have you known the applicant (in years)*

Name of Employer/Business

Occupation/Job Title

The terms "businesswoman/businessman/manager" are not acceptable

Telephone Number (Home):

Telephone Number (Cell):

Telephone Number (Work):

Employer/Business Address

Street Address City Parish Country

Reference 2

Fill out the details below for Reference 2

Reference Type

Title*

Other

Name*

First Middle Last

Current Home Address*

Street Address City Parish Country

Nationality*

Other Nationality

Type of Reference*

How long have you known the applicant (in years)*

Occupation/Job Title*

The terms "businesswoman/businessman/manager" are not acceptable

Name of Employer/Business*

Telephone (Cell)*

Telephone (Home)

Telephone (Work)

Email*

Employer/Business Address

Street Address City Parish P.O. Box/Postal Zone/Zip Code Country

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FOR OFFICIAL USE ONLY

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References Identified?

Section H Citizen Information

Are you a citizen of the United States of America*

Yes

Are you a United States of America Green Card Holder*

Yes

Were you born in the United States of America*

Yes

Are you a United States of America Resident*

Yes

Other country apart from Jamaica and the United States*

Yes

Details

Overseas Address

Street Address City ZIP / Postal Code Country

Overseas Telephone Number

Section I Updating Account

UPDATING ACCOUNT

In keeping with governmental regulations, the personal information on all accounts maintained at the Credit Union MUST be updated every seven (7) years, or as deemed necessary.

I AGREE*

Check to Agree

Section J Closing Your Account

Closing Your Account

A member may be expelled and his/her account closed, if he/she acts in contravention of the Co-operative Societies Act and Regulations or Credit Union rules, acts in any way detrimental to the interests of the Credit Union, acts in the contravention of legislation pertaining to deposit taking institutions, attempts to defraud the Credit Union or is convicted of a criminal act.

I AGREE*

Check to Agree

Section K Obtaining Information

I authorize the Credit Union to obtain additional information from other source as deemed necessary

the undersigned confirm that I have read and understand what is written in this document and also confirm that the information provided herein is true and correct. I authorize the CREDIT UNION to verify all information and to obtain from anyone any additional information that may be required to process this application. I hereby apply for membership in the CREDIT UNION and agree to conform to the rules and amendments thereof and subscribe to the required shares. It is my responsibility to inform the CREDIT UNION of all changes as they affect my member account status.

Herewith please find the sum of $*

being as follows:

Permanent Shares*

Voluntary Shares*

Entrance Fee $*

Other $

Total $

Signature of Applicant

Witness to Signature of Applicant

Manager/Authorized Signature

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Date Approved

DD dash MM dash YYYY

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For Official Use Only: Approval of Membership

This applicant was approved for membership and entered in the Minute Book at a Meeting of the Board of Directors held:

MEMBER ACCOUNT NUMBER

President/ Chairman or Designate

Secretary or Designate

NOMINATION FORM (Pursuant to the Co-operative Societies Act )

Name of Credit Union

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Member Number

Address

Occupation

A member of the above named Credit Union, do hereby revoke any previous nomination made by me and do hereby Nominate the following person(s) (none of them being an Officer or Servant of the Credit Union, unless such person is the Husband, Wife, Father, Mother, Child, Brother, Sister, Nephew or Niece of me, the Nominator) to or among whom shall be transferred in my property in the Credit Union, whether in shares, Loans, Deposits or otherwise on such proportions as is set forth below opposite their respective names

A member of the above named Credit Union, do hereby revoke any previous nomination made by me and do hereby Nominate the following person(s) (none of them being an Officer or Servant of the Credit Union, unless such person is the Husband, Wife, Father, Mother, Child, Brother, Sister, Nephew or Niece of me, the Nominator) to or among whom shall be transferred in my property in the Credit Union, whether in shares, Loans, Deposits or otherwise on such proportions as is set forth below opposite their respective names

Nominee 1

Name*

First Last

Address

Telephone Number

Date Of Birth

DD dash MM dash YYYY

Relationship

Occupation

Proportion %

Nominee 2

Name*

First Last

Address

Telephone Number

Date of Birth

DD dash MM dash YYYY

Relationship

Occupation

Proporition %

Nominee 3

Name

First Last

Address*

Telephone Number

Date of Birth

DD dash MM dash YYYY

Relationship

Occupation

Proportion %

Nominee 4

Name

First Last

Address

Telephone Number

Date

DD dash MM dash YYYY

Relationship

Occupation

I Further Appoint

Trustee 1

Name

First Last

Address

Date of Birth

DD dash MM dash YYYY

Phone

Relationship

Occupation

Trustee 2

Name

First Last

Address

Date of Birth

DD dash MM dash YYYY

Phone

Relationship

Occupation

IN WITNESS WHEREOF I have hereunto set my hand this*

day of*

20*

Signature of Member Making Nomniation/Parent/Guardian*

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Signature of Witness 1

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Address of Witness 2

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Signature of Witness 2

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Address of Witness 2

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I Declare that the present nomination was deposited with the credit union on

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Signature of Secretary or Designate of the Credit Union

JDF Co-operative Credit Union Ltd.