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How do I fill this out?

To complete this form, start by indicating whether you have any convictions. If you select 'Yes', provide detailed information about those convictions. Finally, ensure to sign and date the affidavit.

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How to fill out the Pennsylvania Credit Union Sworn Statement Form?

  1. 1

    Read the instructions carefully before filling out the form.

  2. 2

    Indicate if you have ever been convicted of a relevant misdemeanor or felony.

  3. 3

    If applicable, provide complete details of the conviction.

  4. 4

    Complete your personal information as required.

  5. 5

    Sign the affidavit in the presence of a Notary Public.

Who needs the Pennsylvania Credit Union Sworn Statement Form?

  1. 1

    Credit union officers who must comply with state regulations.

  2. 2

    New employees at credit unions undergoing background checks.

  3. 3

    Committee members requiring verification of integrity.

  4. 4

    Existing employees needing to update their status.

  5. 5

    Board members ensuring compliance with legal requirements.

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What are the instructions for submitting this form?

To submit this sworn statement, you may fax it to the Pennsylvania Department of Banking at 717-787-8773. Alternatively, you can mail it to the Department at Market Square Plaza, 17 N Second St, Suite 1300, Harrisburg, PA 17101-2290. Ensure to follow up on the submission to confirm receipt, and consult with your credit union for any additional requirements.

What are the important dates for this form in 2024 and 2025?

Important dates for the Pennsylvania Credit Union Sworn Statement may vary. Ensure to check for any deadlines or updates that apply in 2024 and 2025, as compliance is essential for all relevant parties.

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What is the purpose of this form?

The purpose of the Pennsylvania Credit Union Sworn Statement Form is to ensure the integrity and transparency of credit union officials. This form requires individuals to disclose any past criminal convictions, particularly those related to dishonesty or breach of trust. By completing this form, credit union personnel affirm their commitment to uphold ethical standards within the financial industry.

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Tell me about this form and its components and fields line-by-line.

This sworn statement includes several fields that require personal information and disclosure of criminal history.
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  • 1. Conviction Disclosure: Indicate whether you have any past convictions.
  • 2. Details of Conviction: Provide specifics if you answered 'Yes'.
  • 3. Personal Information: Enter your full name and contact details.
  • 4. Affidavit Signature: Sign the document in the presence of a Notary Public.

What happens if I fail to submit this form?

Failure to submit this form can lead to non-compliance with Pennsylvania regulations. This may result in disciplinary actions from your credit union. It is crucial to complete and file this document timely to avoid any legal repercussions.

  • Regulatory Penalties: Non-compliance can result in fines or penalties imposed by the state.
  • Employment Issues: Failure to submit may affect your status or employment at the credit union.
  • Legal Consequences: Individuals may face legal issues for not disclosing required information.

How do I know when to use this form?

You should use this form whenever you are appointed or reappointed to a position within a credit union. It's also necessary during annual disclosures as part of compliance checks. Understanding when to use this form is crucial for maintaining regulatory standards.
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  • 1. Upon Appointment: Required when assuming a role within a credit union.
  • 2. Annual Compliance: Mandatory for yearly compliance checks.
  • 3. During Background Checks: Essential for employment screenings.

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Pennsylvania Credit Union Sworn Statement Form

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