Staff Cancellation of Membership

Submitted by:

Date:

FORM FIELDS

If the Member is employed by one of our Postal Only Employers please send out a Cancellation Form by post rather than complete this version

Member Name:*

Member Number:*

Contact Number:*

Main reason for closing account:*

Loan refusal
Change in circumstances / No longer needs account
Dormancy exercise
Moving employment
Retiring
Unhappy with service
Other

Reason if other & space for addition comments:

OUTCOME OF CALL

Proceeding with closure?*

Action following turnaround:*

Action regarding lottery:*

If changing to NRD what is the current savings balance?

SERVICE FEEDBACK

Scotwest aims to provide the highest levels of member service at all times. During your membership with us, how satisfied were you with the level of service you received?*

Additional comments received or reason question not covered:

What has been your main method of contact with us?*

Is there anything else we could do to improve the level of service we provide to our members?

Tick all points covered during the call

Life savings protection
Loan protection
Competitive interest rates
Dividend on savings
Direct Debit possibilities
Other

Other points covered:

IF PROCEEDING WITH CLOSURE, PLEASE COMPLETE ALL RELEVANT FIELDS BELOW

Current deduction method:*

Payroll
DD
Payroll & DD
Standing Order - please ensure member is advised to cancel personally
Benefits - please ensure member is advised to cancel personally
N/A already NRD

Is the member leaving or retiring from employment?

Yes
No

If YES, has salary already stopped?

Yes
No

Is there a current loan balance?

Yes
No

If YES, has loan to be cleared by transfer?

Yes
No

If NO, settlement figure given:

BANK DETAILS

If closure is proceeding, please provide details of the bank account to be used for closure funds.

Account Number:

NO spaces

Sort Code:

NO spaces

Name of bank or building society:

Address or bank or building society:

Building Society reference number (if applicable):