FSCU | Payroll deduction form

Payroll deduction form

Flamesavers CU Ltd
4 Kingsyard, Rope Street, Stoke-on- Trent Staffs ST4 6DJ Tel: 01782 615220
Email: office@flamesavers.co.uk www.flamesavers.co.uk
Reg.No. 338C. Established 1993

member details

Title *

First Name *

Surname *

Membership Number (If you have not yet received your membership number enter NEW) *

National Insurance Number *

Email *

Address details

Address Line 1 *

Postcode *

Service details

Pay number *

Station/Workplace *

Declaration

As a member of the above Credit Union I hereby request the following amendment to my current payroll deduction

Amend the current deduction of £ (If this is a new payroll deduction please type NEW) *

Amend to £ *

In submitting this form to agree to changes to your current payroll deduction with Flamesavers Credit Union Ltd

Type I AGREE into this box to confirm your change of payroll deduction