Online Joint Membership

Step 1 - About You

Membership of Dubco Ireland is currently open to the following groups and their extended family members:

All permanent, continuous and contract employees & retirees of those working in the following sectors:

Local Authorities
Special Needs Assistant members of Fórsa Trade Union
Fast Moving Consumer Goods (FMCG) Employees including
1. Wholesale and Retail Grocery Employees
2. Wholesale and Retail Pharmacy Employees
3. Employees in Pharma & Grocery Manufacturers
Dental Employees including Dentists, Orthodontists, Dental Nurses, Hygienists & Administrative Employees
Non-teaching Employees in all levels of the Education Sector including public & private organisations
Government Organisations including the Housing Finance Agency & Tusla
Members of the CSNA (Convenience Stores and Newsagents Association) and their Employees

Membership is also open to members of the families of any of the previously mentioned groups

Is one of the applicants eligible to be a Dubco Credit Union member? *YesNo

For the eligible applicant, please tick the box to show how you are eligible: *Place of workFamily member

If you have ticked no, please review the criteria above.

Relationship to Existing Family Member? *

Name of Family Member: *

Street Address: *

City/Town: *

County: *

Phone: *

Dubco may contact your family member to verify your relationship to them.

yesWe confirm I have downloaded and understood the membership information pack and its terms and conditions.

Step 2 - Becoming A Member

Becoming a Dubco Credit Union member is simple. However, each applicant will need to provide the following:

Proof of ID - must be within date (currently valid):

Passport
EU National Identity Card (EU Country)
Birth Certificate

Proof of Address - must be dated within the last 6 months:

If the child cannot provide proof of address, then proof of address of one parent along with photo ID of that parent is acceptable

Utility Bill / Confirmation of Insurance Letter (Home/Car)
Statement from Bank/Building Society / Credit Union (not Dubco Ireland)
Revenue Commissioners Correspondence
Document issued by Government Department showing your address and PPS number

Proof of PPS Number¹:

Correspondence from Revenue Quoting PPS Number
Drugs Payment Scheme Card, E111 Card

PLEASE NOTE WE ARE NOT ABLE TO ACCEPT THE PUBLIC SERVICES CARD FOR ANY OF THE ABOVE.

¹PPS Number is not obligatory but would be appreciated. Dubco is obliged to ask for proof of PPS Number.

Step 3 - Applicant Details

Applicant 1

Name: *

PPS Number: *

Date of Birth: *

Day:

Month:

Year:

Age *70

Phone/Mobile: *

Street Address: *

City/Town: *

County: *

Eircode: *

Find your Eircode

Email (Mandatory) *

Employment Details

A copy of your payslip may be required (if applicable) as proof of Common Bond¹.

Employer Name: *

Occupation: *

Employer Address: *

From where do you derive your wealth (i.e. the source of wealth)? For example, employment, savings, investments, etc. *

For what purpose do you require the account (i.e. the business relationship)? For example, savings, loans, budgeting, etc. *

Applicant 2

Name: *

PPS Number: *

Date of Birth: *

Day:

Month:

Year:

Age *70

Phone/Mobile: *0 / 15

Street Address: *

City/Town: *

County: *

Eircode: *

Find your Eircode

Email (Mandatory) *

Employment Details

A copy of your payslip may be required (if applicable) as proof of Common Bond¹.

Employer Name: *

Occupation: *

From where do you derive your wealth (i.e. the source of wealth)? For example, employment, savings, investments, etc. *

For what purpose do you require the account (i.e. the business relationship)? For example, savings, loans, budgeting, etc. *

¹For more information, please refer to page 2 of the Member Information Pack.

Step 4 - Declarations

Are you a Politically Exposed Person (PEP)1, or a close associate or family member of a PEP?

Applicant 1: *YesNo

Applicant 2: *YesNo

Applicant 1, if you’ve selected ‘Yes’, please explain why: *

Applicant 2, if you’ve selected ‘Yes’, please explain why: *

I confirm I am and will be the Beneficial Owner1 of the funds in the account:

Applicant 1: *YesNo

Applicant 2: *YesNo

Applicant 1, if you’ve selected ‘No’, please explain why, and include the name and address of the Beneficial Owner: *

Name of beneficial member:

Street Address:

City/Town:

County:

Applicant 2, if you’ve selected ‘No’, please explain why, and include the name and address of the Beneficial Owner: *

Name of beneficial member:

Street Address:

City/Town:

County:

I confirm that I am a Tax Resident1 in the Republic of Ireland Only:

Applicant 1: *YesNo

Applicant 2: *YesNo

Applicant 1, if you ticked ‘No’, please give the following information:

Tax Identification Number (TIN) of Applicant 1 (proof will be required): *

Country of Tax Residence of Applicant 1: *

Applicant 2, if you ticked ‘No’, please give the following information:

Tax Identification Number (TIN) of Applicant 2 (proof will be required): *

Country of Tax Residence of Applicant 2: *

I confirm that I’ve read the Depositor Guarantee Scheme1 Information in the Member Information Pack:

Applicant 1: *Yes

Applicant 2: *Yes

I confirm that I’ve read the European Union (Payment Services) Regulations 20182 Information in the Member Information Pack:

Applicant 1: *Yes

Applicant 2: *Yes

¹For more information, please refer to page 2 of the Member Information Pack.
²For more information, please refer to page 3 of the Member Information Pack.

Step 5 - Marketing And Other Preferences

Marketing

From time to time, Dubco Credit Union may wish to use your details to inform you of goods and/or services which may be of interest to you.

Dubco Credit Union will not forward your details to any third-party for marketing purposes.

We consent to Dubco Ireland Credit Union informing us of their goods or services that may be of interest by:

Mobile: *

Email: *

Other preferences

Please include us in the Monthly Members’ Draw (currently €4.25 per month): *YesNo

Please include us in the Death Benefit Insurance (DBI) Scheme (currently €4.20 per month): *YesNo

Were you a member of Dubco Ireland previously?

Applicant 1: *YesNo

Applicant 2: *YesNo

Membership No. *

Once your account is approved, we will be in touch to setup your online account access. Statements and AGM notifications will then be sent electronically.

Death Benefit Insurance is applied to the first named applicant only. Please note that a member can only be included in the DBI Scheme once. So if you are already included on your single account, you can not be included in respect of the joint account.

¹Please see the information pack for further information.
²Subject to change, the Death Benefit Insurance Scheme cost is voted upon at the AGM annually. Please note that only Applicant 1 is covered by this scheme.

Step 6 - Account Mandate / Regulatory Requirements

The only person entitled to vote in respect of the account is: *Name:

Note: Where the Board of Directors is satisfied, after considering medical evidence, that an applicant who is incapable by reason of a mental or physical condition to manage and administer the property in the account, the responsibility shall pass to the alternate applicant.

Applicant 1 Name: *

Date *

Applicant 2 Name: *

Date *

For the avoidance of doubt, this is not an application for credit as defined by the Consumer Credit Act, 1995. However, the information contained in this application together with the Dubco Consents to use and disclosure for the purposes of (i) the General Data Protection Regulation (GDPR) (Data Protection Acts 1988-2018) and s.71, Credit Union Act, 1997, and (ii) the Irish Credit Bureau and any other Credit Institution, may be used in conjunction with any and all future applications for Credit Facilities from Dubco Credit Union Limited the Member may submit.
Type of Account Opened: Member should be aware that the Account opened will be treated as a ‘Special Share Account’. This means that the dividend due on this account will be credited net of DIRT (Deposit Interest Retention Tax) by the Credit Union. The tax applied will be the prevailing rate.
The Payment Services Information / ‘Regulation 76 Information’ / ‘The European Union (Payment Services) Regulations 2018’ sets out the terms and conditions relating to electronic payments to and from Dubco accounts, including Share Accounts, Deposit Accounts, Loan Accounts and Budget (Bill Payment) Accounts.
I hereby apply for membership of and agree to abide by the rules of Dubco Credit Union Limited and declare that the information given by me on this form is true and correct to the best of my knowledge. I understand that any false or misleading information given by me in connection with my application for membership with the Credit Union may result in termination of my membership, apart from any other legal sanctions that may apply
I confirm I will notify the Credit Union in writing of any changes in the information which I have provided and any other relevant/material information of which I may become aware at any time after the date of this Declaration.

I understand that under the General Data Protection Regulation (GDPR), my consent may be required for the Credit Union to process personal data that it may have in its possession concerning me (including disclosure to third parties). I note that this personal data may include sensitive personal data, such as data about my health, within the meaning of the GDPR, the processing of which requires my explicit consent.

Applicant 1 Consent: *Yes

Applicant 2 Consent: *Yes

I also understand that under Section 71 of the Credit Union Act, 1997, the Credit Union, subject to exceptions listed in the Section, shall not disclose or permit to be disclosed, without my consent, any information that concerns an account or transaction of mine with the Credit Union.

Applicant 1 Consent: *Yes

Applicant 2 Consent: *Yes

Step 7 - Authority And Indemnity For Telephone Or Electronic Instructions

This allows us to take instructions from you in relation to your joint account by phone or email.

Applicant 1:

Personal Email:

Work Email (optional):

Instructions by email will only originate from one of the following email addresses.

Should I require you to transfer money from my Dubco account to my bank account by Electronic Funds Transfer, the following details are those I shall confirm when I instruct Dubco Credit Union Limited to do the transfer:

Bank Name:

Bank Address:

Account Name:

Bank Identifier Code (BIC):

International Bank Account Number (IBAN):

Applicant 2:

Personal Email:

Work Email (optional):

Instructions by email will only originate from one of the following email addresses.

Should I require you to transfer money from my Dubco account to my bank account by Electronic Funds Transfer, the following details are those I shall confirm when I instruct Dubco Credit Union Limited to do the transfer:

Bank Name:

Account Name:

Bank Identifier Code (BIC):

International Bank Account Number (IBAN):

To: Dubco Credit Union Limited (The "Credit Union")

I refer to my Dubco account (s) and mandate (hereinafter referred to as “the Mandate”) between the Credit Union and myself governing the operation of my account(s) with the Credit Union.
Notwithstanding the terms of the Mandate or of any future mandate or other agreement or course of dealing between the Credit Union and myself
I hereby request and authorise the Credit Union (but do not oblige the Credit Union) to rely upon and act in accordance with any instruction or
communication which may from time to time be or purport to be given by telephone, facsimile or electronic transmission by myself.
The Credit Union shall be absolved of any and all responsibility for any loss or liability of any nature (direct or indirect) suffered by me as a result of any error in transmission of any telephone, facsimile or electronic instruction or communication or as a result of the Credit Union’s acting on any telephone, facsimile or electronic instruction or communication the Credit Union believes in good faith to have been made by me and the Credit Union is authorised to act without further enquiry upon any telephone, facsimile or electronic instruction or communication believed in good faith by the Credit Union to be an instruction or communication so given or made.
The terms of this Authority and Indemnity shall remain in full force and effect unless and until the Credit Union receives (and has reasonable time to act upon) a note of termination from me in writing save that such termination will not release me from my liability under this Authority and Indemnity in respect of any act performed by the Credit Union in accordance with the terms of this Authority and Indemnity prior to the expiry of such time.
Dubco Credit Union Limited reserves the right to request you to attend their office in person for such purposes and requirements as may be deemed necessary by Dubco Credit Union Limited.

Applicant 1 Consent:Agree

Date

Applicant 2 Consent:Agree

Date

Step 8 - How To Fund Your New Dubco Ireland Credit Union Account

How will this account be funded?: *Once-off paymentOngoing payments

A member of our staff will contact you to arrange a lodgement (e.g. counter lodgement, card payment, EFT, etc.) to your new account.

Payment By: *Direct debitPayroll deduction

Payroll Number: *0 / 50

Frequency: *WeeklyFortnightlyMonthly

How much would you like paid into your Dubco account?

Total Amount: *This is the total figure which will be taken out of your payroll going forward.

Preferred Collection Date: *

DIRECT DEBIT MANDATE - (tick below confirms mandate)
Creditor: Dubco Credit Union Limited, Little Green Street, Dublin 7. Creditor Identifier: IE98-ZZZ3-038-18
Please provide the details of the account you will use to fund your Dubco account:

Account Name: *

Bank Identifier Code (BIC): *

International Bank Account Number (IBAN): *0 / 34

Click yes for an additional set of bank fields:yesno

Frequency: *WeeklyFortnightlyMonthly

How much would you like paid into your Dubco account?

Total Amount: *This is the total figure which will be taken out of your payroll going forward.

Preferred Collection Date: *

Account Name: *

Bank Identifier Code (BIC): *

International Bank Account Number (IBAN): *

CONSENT

By ticking the checkbox below, we hereby authorise you to implement the payment mandate selected at the top of this page:

Payroll mandate
Deduct the sums above from my pay/pension each payday until further notice. The money so deducted is to be credited to my account(s) with Dubco Credit Union Limited.
This mandate replaces any existing authorisation to transfer funds to Dubco Credit Union Limited.

Name of Applicant providing the Payroll Deduction: *

Direct debit mandate
(A) Send instructions to my bank to debit my account and
(B) For my bank to debit my account in accordance with the instructions from Dubco Credit Union Limited.
As part of your rights, you are entitled to a refund from your bank under the terms and conditions of your agreement with your bank. A refund must be claimed within 8
weeks starting from the date on which your account was debited. Your rights are explained in a statement that you can obtain from your bank.

Name of Applicant for Direct Debit Mandate: *

Mandate Consent: *Agree

Date *

A member of our staff will contact you to arrange a lodgement to your new account; e.g. counter lodgement, card payment, EFT, etc.

Online Joint Membership

Step 1 - About You

Membership of Dubco Ireland is currently open to the following groups and their extended family members:

All permanent, continuous and contract employees & retirees of those working in the following sectors:

Membership is also open to members of the families of any of the previously mentioned groups

If you have ticked no, please review the criteria above.

CONTACT US

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