Change of Address T 1300 655 116 F 02 9965 1222 P Locked Bag 7003 Concord West NSW 2138 E
[email protected]
Personal details Existing member title
Mr
Mrs
Ms
Miss
On 1 February 2018, the business of My Credit Union Limited was transferred to Community CPS Australia Ltd ABN 15 087 651 143, AFSL/Australian Credit Licence 237 856 trading as Beyond Bank Australia Member no.
Other
Existing member name
Change of address details New residential address State
Postcode
State
Postcode
New mailing address (as above)
Home phone
(
)
Mobile phone
Work phone
(
)
Email address
Effective date
/
/
Change of address also applies to Joint Member Child’s account Business account
Member number and full name
Member number and full name
Member number and full name
Insurance Do you have insurance policies with My Credit Union that also need changing?
Yes
No
Membership signature(s) Member 1 signature
Date
/
/
Member 2 signature
Date
/
/
Branch use only
Newcastle Use Only
Member 1 sig verified
No change to residency
Member 2 sig verified
If change to residency:
Details updated
Tax status updated
Details updated with Allianz
Tax Residency form provided to mbr
Form emailed to Newcastle
AML Officer notified
Form checked
Completed by
Form scanned to member file
Op No. Date
/
/
Completed & reviewed by
Tax residency noted If change to residency: Confirmed AML Officer aware F008_4 02/18
