INTEREST AND DIVIDEND TRANSFER REQUEST FORM

Please fill fields highlighted in red and submit.

Name of Member

Account Information

Select branch: Browns TownKingstonLinsteadMandevilleMay PenMontego BayMorant BayPortmorePort AntonioPort MariaSanta CruzSavanna-la-Mar

Date of Birth

Address

Contact Information

Please enter your phone number excluding all special characters (e.g. brackets, dashes, spaces)

ID Information
ID

Select ID Type
PassportDriver's LicenseVoter's ID
TRN

I hereby request a transfer of my 2022 Interest & Dividend from my Shares to my Easi Access Savings Account.

By submitting your name on this form, you have authorized JTACCUL to accept this as your consent and intent to sign electronically. Also, I agree to the Terms & Conditions of the JTA Co-op Credit Union Ltd.

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