MyJunior

AccountApplication Form

www.sacu.ie

ACCOUNT NUMBER:

Junior Member Application Form

Section A Junior Member Details (Under 16)

Please complete all sections in block capitals

Account Number:

First Name(s):

Surname:

Date of Birth: / /

Address:

_______________________________________________________________________

_______________________________________________________________________

_______________________________________________________________________

Eircode: ____________________________________________________________

The Parent(s)/Legal Guardian(s) who opened account is the only person that can withdraw from the account

The child must be present for all withdrawals & must be accompanied by the Parent(s)/Legal Guardian(s) that originally opened the account

The child is the only person that can withdraw (with Photo Identification). If the junior member does not have any Photographic Identification then they must be accompanied by the Parent(s)/Legal Guardian(s) who originally opened the account. Parent(s)/Guardian(s) must produce Photo Identification

Who can withdraw from a Junior Account?Money in a junior account is the sole property of the child and no other person (including the Parent(s)/Legal Guardian(s) or person who originally opened the account) is entitled to use this money for his/her benefit.

< 7 years

12 - 15 years

7 - 11 years

16 years +

A junior account becomes an adult account when the child turns 16. At this point, they will need to provide current photo ID and proof of address in their own name

Section B Junior Member SignatureI hereby apply for membership of and agree to abide by the rules of St. Anthony’s & Claddagh Credit Union Ltd. I declare that the information given by me on this form is true and correct to the best of my knowledge and belief.

Signature: Print name: Date:

Witness: Print name: Date:

Section C Parent(s) / Legal Guardian(s) DetailsParent / Legal Guardian Second Parent / Legal Guardian

Full Name: ________________________________________________

Membership Number: ___________________________________

Address: ___________________________________________________

______________________________________________________________

______________________________________________________________

______________________________________________________________

Eircode: ___________________________________________________

Mobile No: ________________________________________________

Full Name: ________________________________________________

Membership Number: ___________________________________

Address: ___________________________________________________

______________________________________________________________

______________________________________________________________

______________________________________________________________

Eircode: ___________________________________________________

Mobile No: ________________________________________________

Section D Parent(s)/Legal Guardian(s) SignatureI / We hereby apply for membership in the name of the said ________________________________________ and I / We acknowledge that all shares / deposits arising from this membership now and hereafter shall be his / her sole property and all withdrawals shall be applied to his / her sole benefit. In the event of the account being opened by more than one Parent/Legal Guardian it is required that both parties/either parties be present to make withdrawals.

Section E

The details provided in this application form together with any other information that is furnished to us in connection with this application will be retained and processed by St Anthony’s & Claddagh Credit Union Ltd., in accordance with our Data Privacy Statement. Please take time to read this document which is available to you at www.sacu.ie or in any of our branches

Please initial the box to confirm that you have received our Privacy Notice.

DATA PROTECTION AND DATA PRIVACY STATEMENT

Please initial the box to confirm you have received your ‘Framework Contract‘ and associated information for the purpose of the Regulations

EUROPEAN COMMUNITIES PAYMENT SERVICES REGULATIONS 2018

Please initial the box to confirm receipt of the Depositor Information Sheet

DEPOSIT GUARANTEE SCHEME

Section F Anti Money Laundering Compliance

What is the expected source of funds and expected nature of account:

Regular savings Regular savings & withdrawals Sporadic savings Other

What is the expected turnover per annum on account?

<€1,000 €1,001 - €2,500 €2,501 - €5,000

Source of funding: Parent(s) Contribution Gifts: Child Benefit:

Savings from another financial institution Other:

Nationality: Country of Origin:

Under the Criminal Justice Act 2010 we require the following:

Are you or a member of your immediate family or close associate a Politically Exposed Person*:

Yes No Signature:

*A “PEP“ is a person who holds, or has held within the previous year, a prominent public function (e.g. Government Minister, High Court Judge, High-ranking Army Official), or a member of the PEP’s immediate family (e.g. spouse / civil partner, parent, child, daughter / son-in-law, civil partner of a child) or a close associate (e.g. business partner or closebusiness relationship). A “PEP“ could include a Non-Republic of Ireland resident

Signature of First Parent / Legal Guardian Signature of Second Parent / Legal Guardian

/ / / /

Signature:

Date:

Signature:

Date:

The property in a junior account is the sole property of the child. No other person (including the originator of the account) is entitled to use this property for his/her own benefit.

I confirm that the junior member is the beneficial owner of the account: YES

Junior Member Signature: Date: / /

Parent(s)/ Legal Guardian(s) Signature 1: Date: / /

Parent(s)/ Legal Guardian(s) Signature 2: Date: / /

Witness: Date: / /

Opened by: ________________________________ Checked by: __________________________________

Date: _____________________________________ Date: ________________________________________

Section G ID Documents

Under the Criminal Justice (Money Laundering and Terrorist Financing legislation) we are obliged to establish and verify the identity of our members. To enable us to fulfil this obligation, we require the following please:

Original Birth Certificate / Passport Photo ID of Parent(s)/Legal Guardian(s)

Proof of Junior Applicant PPSN Proof of Address in the name of Parent / Legal Guardian / Child

OFFICE USE ONLY

St. Anthony’s & Claddagh Credit Union is regulated by the Central Bank of Ireland.

Head Office: 8/9 Mainguard St., Galway City CentrePhone: 091 537200 Email: info@sacu.ie www.sacu.ie

St. Anthony’s & Claddagh Credit Union is regulated by the Central Bank of Ireland.

TAX RESIDENCY FOR THE PURPOSES OF THE COMMON REPORTING STANDARD

If you are a tax resident in another country, please provide your Tax Identification Number (“TIN”) and Country of Residence:

I confirm that the information provided is true and correct to the best of my knowledge, and that if my circumstances change, I will notify the Credit Union:

Name: ________________________________________________ Date: __________________________

If you are not tax resident in another country, please sign the following:

I wish to declare that I am not resident for tax purposes in any other country and that if my circumstances change, I will notify the Credit Union:

Name: ________________________________________________ Date: __________________________

*Mandatory Field**This information is being sought for the purposes of reporting obligations under the Common Reporting Standard (CRS), as provided for the Section 891f of the Taxes Consolidation Act 1997. The information required to be reported under the CRS, including name, address, TIN, account number, account balance, and payments on the account will be provided to the Revenue Commissioners and may be exchanged securely with another Competent Tax Authority in your jurisdiction of tax residence, but such information will at all times be treated with the strictest confidentiality as required by the Data Protection Acts 1988 & 2003. Only data that is legally required to be reported will be provided to the Revenue Commissioners. For more information on this, contact Revenue at www.revenue.ie

1. TIN*

Country of Tax Residence*_______________________________

2. TIN*

Country of Tax Residence*_______________________________