Thank you for submitting your Shareholder Declaration. Your request has been received and will be processed.Direct Dividends FormYou are filling out this form because you have opted to receive direct dividends from BCSD.First Name:*Middle Name:Last Name:*NIB#:*Telephone#:*Email:*Confirm EmailBank Name:*Branch:*Account#:*Add Joint Shareholders?No YesFull Name:*NIB#:*Full Name:NIB#:Full Name:NIB#:Full Name:NIB#:Full Name:NIB#:Upload Photo or Scan of NIB Card*Drop files here or click to select% Completed0Upload Photo or Scan of Driver's Licence or Passport*Drop files here or click to select% Completed0Digital Signature: Submit
