Statement / Letter Request Form.

Request a statement/online by completing the form below. Your document will be processed within 24 hours of the request, except on weekends or public holidays, where it will be processed the next working day.

Member / Account Number: *

First Name: *

Last Name: *

Email Address: *

Mobile Number: *

Home Number:

Type of Statement: *

Select Branch for Collection: *

PLEASE ADDRESS STATEMENT / LETTER TO:

Name:

Position:

Name of Institution: *

Address / Branch of Institution: *

Please note statement / letter can be collected at the respective Member Services Department.

Collection Details / Special Instructions:

Is someone collecting on your behalf? *

YES NO

Please provide the name and id information of the person collecting.

Full Name:

ID Number:

PAYMENT OPTIONS:

A $25.00 processing fee is payable for each statement requested.

I authorize PCU to debit my deposit account Pay on collection at branch

*Statements will be processed within 24 hours of the request, except on weekends or public holidays where it will be processed the next working day.

**A valid form of ID is required to collect.
For someone to collect on your behalf, you must provide a signed letter of authorisation accompanied by a copy of your identification. The person collecting must also bring valid photo identification as indicated in the authorisation letter.

Notes / Comments:

Declaration *

I accept responsibility for the accuracy of all information provided by me on this form and I understand that the Credit Union relies on this information to provide the service.

Statement / Letter Request Form.

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