Personal Details, Credit Union and Rent

Savings and Rent Account Application Form

Title:

Full Name: Address:

Rent Reference:

Contact Tel: Email Address: N.I. Number:

Date of Birth: Nationality:

Family Housing Association and LASA (Loans and Savings Abertawe) Credit Union are working in partnership to provide you with a FREE account which can be used by you to pay your rent;

How does this work?

 Family Housing Association pays for you to become a member of LASA Credit Union

and you get a rent account to be used exclusively to pay your rent.

 You make regular payments into the Credit Union rent account.

 The payments you send to the rent account can be benefits you receive from the

government i.e. Child Benefit, Job Seekers Allowance, and Tax Credits or you can set up a Standing Order from a bank account.

 Payments come out of the account to pay your rent/shortfall in your rent.

 If the amount paid into the Credit Union is more than your rent, you can save this

money or access it from the Credit Union.

What are the benefits of the free rent account and this scheme?

 The rent account is set aside from your other finances; therefore it is a safe account

which can be used by you to solely manage your rental payments.

 Monies paid in will not be used to pay off any other debt.

 When you become a member of LASA Credit Union you will have access to other

financial products and services offered by LASA Credit Union.

Postcode:

Home: Mobile:

Length of time at current address:

Previous address if less than 3 years at current address

Postcode: Mr / Mrs / Miss / Ms / Other

Supporting Information

 To join this scheme you will need to provide details of your income, and complete

some forms to tell your employer, the Department for Work and Pensions or Her Majesty’s Revenue and Customs to pay your income directly into your Credit Union rent account. Your income will then be used to pay all or some of your rent.

 It is your responsibility to tell the Credit Union how much you want to pay towards

your rent and how often.

I have read and understood this information. I also understand that it is my responsibility to pay my rent and that if I get into arrears and do not make any arrangements to pay my rent in full, I risk losing my home

I would like to become a member of LASA Credit Union and take up the offer of a ‘free’ rent

account Signature:

Anti-Money Laundering Regulations: In order to comply with the regulations, we require proof of identity and address with all new Membership Applications, which can be any two of the following:

Driving Licence (photo card and paper part), Passport, Recent Utility Bill, Benefits Letter, Bank/Credit Card statement, HMRC tax notification (current year), Student ID card. If you can't provide two items from the list above, please contact us to discuss what else you could use.

Data Protection Statement: In accordance with the principles of the Data Protection Act 1998, we will use your personal details for the purpose of managing your accounts with the Credit Union. Your personal details will be treated confidentially and will only be shared with other agencies for the purpose of credit referencing and debt recovery for which we hold a Consumer Credit Licence under the appropriate category. You also have a right of access to the personal information we hold on you.

Information we hold will be used to inform you about other products and services offered by the credit union that we believe may be of interest or assistance to you, if you do not wish to receive such information please place a tick in this box:

About you

Are you? Employed Employer

On Benefits Benefits Retired

Marital Status:

Do you have any special needs that we should be aware of when serving you?

Please indicate your preferred method of contact:

Form of Nomination

In the event of my death, I nominate the following person to whom there shall be transferred such property in LASA credit union as may be mine at the time of my death, whether in shares or otherwise.

Name: Contact Tel:

Address:

Relationship:

Signature of Applicant:

Printed name of Witness:

Signature of Witness:

Declaration

I hereby apply for membership and agree to abide by the rules of Loans and Savings Abertawe (LASA) Credit Union Ltd. I declare that the information provided on this form is true and correct to the best of my knowledge and belief:

Print Name:

Signature: Date:

Single / Living with Partner / Married / Other

By Post / By Email / By Phone

The witness shall not be the nominee

Postcode:

FOR OFFICE USE ONLY:

Proof of Address and ID photocopied. Date: __________ By: ______________ Entered on Kesho? Date: ____________ By: _____________ Card Sent? ____

Benefit Payment Instruction

Member Information

Benefit Information

You can have your state benefits paid into your LASA Credit Union account. The benefit can then be used to repay a shortfall in your rent if you wish to do so. To do this you will need to contact the relevant Benefit Office.

Declaration

I wish to have a benefit paid into my LASA Credit Union account. I understand that I will have to contact the appropriate benefit office, to arrange the benefit to be paid into my LASA Credit Union savings account (details provided overleaf). I give permission for LASA Credit Union to pay Family Housing Association any shortfall I owe towards my rent as stated below:

I agree to pay £__________ towards the shortfall in my rent to Family Housing

Association every week / fortnight / month. I understand that LASA Credit Union will

only make this payment if sufficient funds are in my account, and it is my responsibility to contact LASA Credit Union if payments change. I give consent to LASA Credit Union to contact Family Housing Association if payments towards my rent shortfall stop.

Name: Membership Number:

National Insurance Number:

Type of benefit you wish to pay in (please circle):

Job Seekers Allowance Employment Support Allowance Child Benefit

Working Tax Credit Child Tax Credit Personal Independence Payment Income Support Pension Credit Widows Pension Carers Allowance

Benefit Reference:

If you wish to pay in Child Benefit we will need your Child Benefit reference number.

Amount of Benefit: £ _______ Date of first payment:

Frequency of payments: Weekly Fortnightly 4-Weekly Monthly

Print Name:

Signature: Date:

If you have any funds still in savings after the shortfall has been paid, then the funds can be loaded onto a Prepaid Debit Card and withdrawn from the account.

Benefit Office Contact Details:

To have your benefit paid into your Credit Union account, you will need to contact the relevant benefit office.

Below is a list of contact numbers for each benefit office (contact details correct at time of print):

Child Benefit Helpline 0300 200 3100 Tax Credit Helpline 0345 300 3900 State Pension Helpline 08456 060 265

DLA Helpline 08457 123 456

PIP Helpline 0845 850 3322 ESA/JSA Helpline 0845 600 3016

LASA Credit Union Bank Account Details:

You will need to provide these account details to the Benefit office to have your benefit paid into your Credit Union account.

Account Number: 67060711 Sort Code: 08-90-85

Bank Branch: The Co-operative Bank Swansea

When you contact the Benefit office you will be provided with details of when the first payment is expected to be made into your account. We will need to know this information (see previous page).

Note: If you do not know your Child Benefit reference number, you can get this information from the Benefit Office when you contact them. We will need to know this information so we can deposit your benefit into your Credit Union account.

Standing Order Instruction

This instruction is to continue until further notice and cancels any previous instructions in favour of Loans and Savings Abertawe (LASA) Credit Union Ltd named under this account. I understand that in the event that payments stop, or change, it is my responsibility to contact LASA Credit Union.

If you wish to set up regular payments from your bank account to pay into your Credit Union account, please complete the details below. We will then send this instruction to your bank and payments will begin as instructed.

Bank Name: Bank Address:

Branch:

Account Name:

Account Number: Sort Code:

Please deduct from my account the sum of:

£

On the day of each week / month starting on

Loans and Savings Abertawe (LASA) Credit Union Ltd Bank Account Number: 67060711

Bank Sort Code: 08-90-85

Bank Branch/Address: The Co-operative Bank Plc

34 The Kingsway, Swansea SA1 5LG For the credit of:

Quoting Reference:

Print Name:

Signature: Date:

FOR CREDIT UNION USE:

Name of Member _________________________ Member Number _________

Easy Rent Payments

Your 5 step guide

Family Housing Association (FHA) and LASA Credit Union are offering you a FREE and easy way to manage your rent and any shortfall you may have as a result of recent Welfare Reform.

Follow this five step guide which explains how this FREE service works.

Open Credit Union Rent Account

You complete a Credit Union Membership Application Form.

Confirm Payment Method into Account

You are given an individual rent account by the Credit Union. Tell the credit union how much you want to pay in. You can pay in money from wages, tax credits, other benefits, or from

a standing order from your bank account.

1

2

..

.

3

4

5

Rent Payments will be made to FHA

You tell the Credit Union how much you want to pay towards your rent and how often. The Credit Union will pay this amount to Family Housing Association on your behalf.

Manage future changes

You let the Credit Union know if you want to change the amount being paid to Family Housing Association.

Withdraw any additional savings

After making the rent payments to Family Housing Association, the Credit Union can put any additional savings

All about your FREE

Credit Union prepaid card

A prepaid card is a pay-as-you-go payment card. Cardholders ‘load’ money onto the card, which can then be used to buy goods and services, or withdraw from cash machines, in the same way as debit cards.

How does it work?

Load money onto the card in your credit union – then use it straight away to withdraw cash or make purchases, just like any Visa card.

Are there any costs for using the card?

Contacting LASA Credit Union

If you have any questions about the Credit Union Rent Account or wish to enquire about other services LASA Credit Union can provide (Savings, Loans and Electrical Goods) you can do so by telephone on: 01792 643632 (lines open Monday-Friday 9:30am-2:30pm) or for more information visit our website:

www.lasacreditunion.org.uk

Cash Withdrawal at a Cash Machine 75p

Loading money onto the card 50p

Cash back at shops FREE

Purchases in shops and online FREE

Monthly Management Fee £2

To have a benefit paid into your Credit Union account you will

need to contact the Benefits Office, to arrange for a benefit to be paid into the Credit Union.

Useful Benefit Office Contact Numbers Child Benefit Helpline 0300 200 3100 Tax Credit Helpline 0345 300 3900 State Pension Helpline 08456 060 265 DLA Helpline 08457 123 456 PIP Helpline 0845 850322 ESA/JSA Helpline 0845 600 3016