Loan Application

Apply for a Loan

* Required Fields

Purpose of Loan:

Term:

Account Number:

Amount Requested:

Applying for a Joint Account:

Yes

Primary Initials:

Joint Initials:

This application initiates the loan process. Applicants must be members of the Credit Union who are currently in good standing. Applicants may be asked to come into the office and sign an application form in person before the loan process can proceed. Final signature(s) will be required to advance funds, including signatures for joint applicants. Please call us if we do not contact you by the next business day.

PLEASE TELL US ABOUT YOURSELF (PRIMARY BORROWER)

Full Name:

Street Address:

City:

State:

Zip:

Years There:

Cell Phone:

Work Phone:

Birth Date:

E-Mail Address:

PLEASE TELL US ABOUT YOUR JOB (PRIMARY BORROWER)

Current Employer:

Years There:

Phone Number:

Position:

Gross Montly Income:

Note: alimony, child support, or separate maintenance income need not be revealed if you do not wish to have it considered as a basis for repaying this obligation

Other Income:

Source:

PLEASE TELL US ABOUT YOURSELF (CO-BORROWER)

Full Name:

Street Address:

City:

State:

Zip:

Years There:

Cell Phone:

Work Phone:

Birth Date:

E-Mail Address:

PLEASE TELL US ABOUT YOUR JOB (CO-BORROWER)

Current Employer:

Years There:

Phone Number:

Position:

Gross Montly Income:

Note: alimony, child support, or separate maintenance income need not be revealed if you do not wish to have it considered as a basis for repaying this obligation

Other Income:

Source:

PLEASE LIST NEAREST RELATIVE NOT LIVING WITH YOU

Full Name:

Home Address:

City:

State:

Zip:

Phone Number:

Security Code:

AGREEMENT

DISCLAIMER: I/WE HEREBY CERTIFY THAT ALL STATEMENTS MADE ARE TRUE AND COMPLETE, ARE SUBMITTED FOR THE PURPOSE OF OBTAINING CREDIT, AND THAT THE CREDIT UNION MAY RELY ON THEM FOR SUCH DETERMINATION. WE UNDERSTAND THAT FEDERAL LAW REQUIRES THE VERIFICATION OF IDENTIFICATION FOR ALL NEW ACCOUNTS SHOULD I NOT HAVE AN EXISTING ACCOUNT. I/WE AUTHORIZE YOU TO OBTAIN SUCH INFORMATION AS YOU MAY REQUIRE CONCERNING THE STATEMENTS MADE IN THIS APPLICATION AND PROPER IDENTIFICATION, AND AGREE THAT THE APPLICATION SHALL REMAIN YOUR PROPERTY, AND YOU ARE AUTHORIZED TO ANSWER QUESTIONS ABOUT YOUR CREDIT EXPERIENCE WITH ME/US.

I accept the terms of the disclaimer above and submit my application.

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Loan Application

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