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Date *
Name *
Marital Status: *
Contact Number: (H) *
Contact Number: (C)
Date Of Birth (Dd/Mm/Yyy): *
Country Of Birth:
Current Address: *
Previous Private Addresses During The Last Ten (10) Years: *
Email Address: *
Nationality: *
Government Issued Identification (Two Forms Of Identification Required):
Identification Card *
If Yes


Driver’s Permit *
If Yes


Passport *
If Yes


Allergies *
If Yes
Are there any judgments against you? *
If Yes Please Specify:



Have you ever been dismissed for any improprieties? *
If Yes Please Specify:

Do you have Shareholdings in any other institutions? *
If Yes Please Specify:




The Credit Union may require you to provide further information on these matters.
Are you a member of any Society or Club? *
If Yes Please Specify:
Are you an officer for any other Society/Club/Institution? *
If Yes Please Specify:
Employment History
Name of Employer Address Position held Duration of Employment Reason for leaving
Education Information
Name of Institution Location Course of Study Duration of Study Certification Attained

Politically Exposed Persons (PEPs)

A PEP is defined by the FATF as “an individual who is or has been entrusted with a prominent public function.” The FATF recognizes that, due to their status and influence, many PEPs are in positions that can be platforms for committing money laundering and related predicate offences. These include corrupt practices and bribery, as well as conducting activity related to the financing of terrorism.
The following examples of domestic PEPS are included in the above definition:*

Head of State – the President of the Republic of Trinidad and Tobago
Head of Government – the Prime Minister
Senior Members of the Legislature e.g. The Speaker of the House and the President of the Senate
Senior Politicians e.g. all Members of Parliament, Government Ministers, Mayors ,, Leader of the Opposition, Chairman and Chief Secretaries of the Tobago House of Assembly, Parliamentary Secretaries
Senior Government Officials e.g. Permanent Secretaries, Chief Technical Officers, an Ambassador or High Commissioner, Assistant Commissioner of Police or higher rank
Judicial Officials e.g. Magistrates, Judges of the Supreme Court, Judges of the Industrial Court, Judges of the Caribbean Court of Justice.
Military Officials – a Lieutenant Colonel or higher rank
Senior executives of State owned corporations e.g. Members of the Boards of all Statutory Bodies and State Enterprises including those bodies in which the State has a controlling interest
Senior political party officials e.g. Chairman, Political Leader and Deputy Political Leader of a political party.
* NOTE: these examples are NOT exhaustive.

1. Are you a Politically Exposed Person (PEP)? *
2. Are you an immediate family to a PEP, meaning, the spouse (includes ex-spouse), parents, siblings or children of that person and the parents, siblings and additional children of the person’s spouse? *
3. Are you a close personal or professional associate of a PEP? *
References

Provide referee 1 details below :

Name of Referee Place of Employment and Occupation Relationship to candidate Contact number of referee

Provide referee 2 details below :

Name of Referee Place of Employment and Occupation Relationship to candidate Contact number of referee

I hereby declare that all information given on this application is true, correct and complete to the best of my knowledge. I understand that misrepresentations, omissions or falsifications of any information so given or other derogatory information discovered as a result of an investigation may result in exclusion from further consideration for employment or immediate dismissal.

Officer’s signature: Date: 21 Jun 2024

KNOW YOUR OFFICER FORM

Kindly provide in original state together with one copy:

  • Two forms of National Identification i.e. Government issued identification
  • Proof of address i.e. Utility Bill, Bank Statement
  • Certificate Of Good Character no older than 3 months
  • Proof of income i.e. Job Letter, Payslip
  • Resume
  • Academic Certificates