Payroll Deduction / Amendment

PAYROLL DEDUCTION /

AMENDMENT

Instructions to your Employer to pay by direct

Payroll Deduction

Please complete this form in block letters and black ink and send it to:

SCVO CREDIT UNION LTD The Mansfield Traquair Centre 15 Mansfield Place Edinburgh EH3 6BB

Name of Applicant

Name of Employer

Department/unit/project

National Insurance Number

Job Title

Instruction to your Employer.

I authorise payroll deduction to SCVO Credit Union Ltd of £

per fortnight / month

* (*delete as appropriate)

By signing this form, I hereby agree to the release of information by my employer in the event of non-payment of

a loan obligation.

Signature(s) ___________________________________________

Date _________________________________

Full Payroll Employee Number _____________________________________

CU reference number (Leave blank until allocated by the CU)

For SCVO Credit Union Ltd use only.

Input date____________ First payment due date_____________

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Parent category: Business