Personal InformationBranch *Head Office - #31 Bethlehem Road, BethelBranch Office - Mt. Marie, Lower ScarboroughPrefixMr.Mrs.Ms.Mx.MissDr.Prof.First Name *Last Name *Home NumberCell Number *Email Address *Account Number *Note: Your Account number is the six digit number found after " / " i.e. No. B01C012 / 001234Information For LetterCompany InformationStatement to be Addressed To *Name of Company *Address of CompanyPurpose of Statement *-Loan BalanceLetter of Non-IndebtednessVerification of AccountBank StatementSettlement LetterTransaction StatementsOtherWhen Statement is Available *-Send Letter To My EmailSend Statement to Company EmailCompany Email Address *Payment InformationPayment Method *-Charge Fee to My BCU AccountCash Payment at the Specified BranchPlease Note: The Processing Fee of $10 must be made within a two (2) day period prior to processing.I hereby authorize the Processing Fee of $10.00 to be withdrawn from my Bethel Credit Union deposit account.DeclarationI hereby apply for the aforementioned Statement from Bethel Credit Union Co-operative Society Limited and agree to abide by the bye laws and rules or any amendment thereof the Credit Union. I declare that I am not engaged in money laundering, terrorist financing, fraud, drug trafficking, identity theft, or any other criminal or illicit activities. Authorization and consent is given to Bethel Credit Union to obtain information about me and verify the submitted information.I agree to the aforementioned declaration to request Statement.Submit Request
