1Start2About You3About the Member4Confirmation Notify us of the Death of a Member You can use this form to let us know about a family member or next of kin who has passed away who had an account with us. Only complete this form if: You are the next of kin or executor of someone who has passed away, and hold the death certificate. The person who has passed away was a member of London Mutual Credit UnionThe address displayed in your address bar begins with 'creditunion.co.uk' and a padlock icon is visible. About YouFirst, please provide some information about yourself, and your relationship to the person who has passed away.Your Name* First Last Email Address* Your Phone Number*We understand this may be a difficult time, so our team will only call you if it's absolutely necessary for us to speak to you.What is your relationship to the person who has passed away?* Spouse Child Parent Other Next of Kin Solicitor Executor About the Person Who has Passed AwayThank you. We'll now need some information about the member who has passed away.Name of the Deceased Person* First Last Their Membership Number If you know the credit union member number of the person who has passed away, this will help us to identify their account more easily.Their Date of BirthDay12345678910111213141516171819202122232425262728293031Month123456789101112Year2025202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920When Did they Pass Away?Day12345678910111213141516171819202122232425262728293031Month123456789101112Year2025202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920Copy of Death Certificate*Accepted file types: jpg, jpeg, png, gif, pdf, Max. file size: 50 MB.Please provide a PDF or clear image copy of the person's death certificate. Photos must be clear with all areas of the page visible and all text readable.Are You the Named Beneficiary on the Account?* Yes No I don't know DeclarationConsent* I declare that the account holder, , passed away on .*Consent* I, , am the of the deceased and I have the legal authority to report the death and initiate the necessary procedures to manage the deceased's financial accounts with London Mutual Credit Union under English law.*Consent* I understand that the credit union may request additional documentation to verify the death of the account holder and the authority granted to me. I hereby agree to provide any required documentation promptly and truthfully.*Consent* I authorise London Mutual Credit Union Limited to take the necessary actions to close, transfer, or manage the deceased account holder's accounts as per the bank's policies and procedures. This may include settling any outstanding debts, transferring funds to designated beneficiaries, and providing necessary information to legal representatives, as applicable.*Consent* I also acknowledge that London Mutual Credit Union Limited will not be held responsible for any damages or losses resulting from acting in good faith upon this declaration until the necessary verification process is completed.*Consent* I declare that the information provided in this document is accurate and complete to the best of my knowledge. I understand that providing false information may have legal consequences under English law.*Your Signature*PhoneThis field is for validation purposes and should be left unchanged.