(State full name below) I, on becoming a member of the Nevis Co-operative Credit Union Limited in accordance with section 106, of the Co-operatives Societies Act, 2011 made there under; and the By-Laws of the above named society, hereby nominate the following as the only person(s) to or among whom to my property in the society, shall be transferred, whether in shares, deposits, or interest held by me in the said society, in the event of my death, in such proportion(s) as is/are set forth below opposite their respective names:

I further appoint the following person(s) as Trustee(s) for the minor(s) nominated above, until he/she attains the age of Eighteen (18), (any Trustee(s) appointed must be Eighteen (18) years of age or older).