
Sheffield
Credit Union
Full name .................................................. Membership no..................
Address ..................................................................................... .....................
Postcode ... Contact telephone number ........................................
I hereby authorise that the sum of £ .................... be taken from my share account and applied to my outstanding loan.
Signed ................................................... Date ................................
________________________________________________________________________
For credit union use
Existing share balance £ .................
Existing loan balance £ ...................
Arrears £ .............................
New share balance £ ......................
New loan balance £ ........................
_______________________________________________________________________
Approved by credit committee:
Name ....................................................... Date ................
Name ....................................................... Date ................
Authorised and regulated by the Financial Services Authority 213679 Produced 08/07/2005