Please note:

  1. Signature is required for all application forms.
  2. Please print and sign on the hard copy after clicking on the ‘Submit’ button.
  3. You may proceed to fax/ email/ mail the completed form to our office.

Alternatively, you may print a blank form and complete them manually here.

"*" indicates required fields

Enter the last 3 digits + last alphabet of your NRIC. E.g. use “567A” if the NRIC number is S1234567A
WITHDRAWAL OF CONSENT

WITHDRAWAL OF CONSENT

The Co-operative collects, uses and discloses your personal data for the following Necessary Purposes:

  1. processing your membership or any form for any of the products and/or services offered by us;
  2. carrying out membership or other information checks;
  3. handling requests, enquiries, feedback and resolving complaints in the provision of products and/or services;
  4. making or obtaining payments;
  5. evaluating your credit and eligibility profile;
  6. deciding whether to insure or continue to insure you for loan applications;
  7. investigating and settling claims;
  8. recovering any debts owed to us;
  9. meeting or complying with Co-operative’s internal policies and procedures and any applicable rules, laws, regulations, codes of practice or guidelines, orders or requests issued by any court, legal or regulatory bodies (both national and international) (including but not limited to disclosures to regulatory bodies, conducting audit checks, surveillance and investigation);
  10. generating financial, regulatory, management or other related reports and performance of analytics;
  11. preventing, detecting and investigating crime, offences or breaches including fraud, money-laundering, counter-terrorist financing and bribery;
  12. legal purposes (including but not limited to enforcing our legal rights, drafting and reviewing documents, obtaining legal advice and facilitating dispute resolution);
  13. maintaining the security of the Co-operative premises (including but not limited to the use of security cameras); and
  14. purposes which are reasonably related to the aforesaid.
I wish to withdraw consent of receiving updates from Police Co-op via:
I wish to withdraw consent for the collection, use and disclosure of:
Please provide details - to be written in print
NECESSARY PURPOSES
DOCUMENTS UPLOAD
The following documents are necessary for the processing of your application.

Please enclose the following documents for the processing of the application:

  1. A copy of my NRIC (front and back).

Max. file size: 60 MB.
CONSENT TO PROCEED

CONSENT TO PROCEED

  1. I declare and confirm that the personal data that I have provided on this form is accurate and complete.
  2. I consent to the collection, use and disclosure of the data for the purpose of complying with my Personal Data Access Request.
  3. I enclose my proof of identity.
  4. I understand that Police Co-op may impose a fee to process my Data Access Request and will provide an estimate of the fee for my consideration. If I do not agree to the payment of the fee, Police Co-op will not be able to process my Data Access Request.
  5. I further understand that Police Co-op reserves the right to restrict access to certain personal data or decline to fulfill my Data Access Request as may be permitted under the Personal Data Protection Act 2012.
SIGNATURE
Please sign using the online pen that will appear when you move within the box.
MEMBER'S SIGNATURE*
Please sign using the online pen that will appear
when you move within the box.

Click the Submit button only once
to prevent duplicate submissions.