BAHAMA ISLANDS CO-OPERATIVE CREDIT UNION (BICCU) LIMITED
WITHDRAWAL REQUEST
DUE DATE: _______________
DATE:_______________________
A/C#:________________________
Member’s Name: _________________________________________________________
(PLEASE PRINT)
Withdraw: __________________________________________________________Dollars
(Words)
($________________)
SAVINGS
(Figures)
CHEQUING
Bank Account Type (Please Circle)
__________________
Direct Transfer Info:
Payable To: ____________________
Bank’s Name & Branch
__________________
Your Account Number
(If Other Than Account Holder/Member)
DISCLAIMER: It is the sole responsibility of the member when requesting a Direct Transfer/Deposit to ensure that the information provided for the
bank’s name, branch, account number and/or account type are correct. BICCU will not be held liable where the information provided is incorrect.
FROM MY: PLEASE TICK ALL THAT APPLY
_____ Bill Paying Account
_____ Christmas Club Account
_____ Kall Account
_____ School Fee/Education Account
_____ Vacation Club Account
____ Regular Savings Account
____ Loan Payment Waiver
____ MasterCard Account
____ KIDDS Club Account
____ Other: ________________
NOTES:
1)
2)
3)
4)
Only 2 FREE withdrawals are allowed from the Christmas Club a/c per year. $25 will be charged for additional withdrawals.
There is a $5.00 Fee for withdrawals from the Bill Paying, School Fee and Vacation Club a/c’s
There is a $10.00 fee for waiving the 30-days wait on Regular Savings Withdrawals.
A Loan Payment Waiver is allowed every six months. The fee of $25.00 is deducted from the requested amount. I realize that
this payment waiver will increase both the balance and term of my loan _______________________
Member’s initials required
Signature_________________________
DO NOT WRITE BELOW THIS POINT – OFFICIAL USE ONLY
VERIFICATION:
Beneficiary
DATE POSTED: _______________
CHEQUE #: __________________
POSTED BY: __________________
KYC Information
Verified By
Date Verified
Please Collect: $25.00 ____
FEE PAID -----------Please Collect: $10.00 ____
Please Deduct: $10.00 ____ $25.00 _____ $50.00 ____
Regular Savings Account Withdrawal & Loan Payment Waiver(s) Approval:
Savings Balance: $___________________
Fixed/Other Balance: $_______________
Loan Balance: $ _____________________
MasterCard Limit: $__________________
Available Balance: $ _________________
Comment: __________________________
___________________________________
Date: _______________________________________________
Approved By:_________________________________________
Comment:____________________________________________
_____________________________________________________
_____________________________________________________