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Consumer Loan
Consumer Loan Application
All information sent to us is stored on a secure server for your safety.
Submit this application today via our secured server, or stop by the credit union for more information. You may also print out this application and mail it or fax it in for processing.
You'll be glad you did.
Notice: Married Applicants may apply for a separate account. Check the appropriate box below to indicate the type of credit for which you are applying.
Applicant Account Number
(*)
Invalid Input
Date
(*)
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CONSUMER LOAN TYPE
Purpose of Loan
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Limit $
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Collateral Secured
Requested Amount: $
Invalid Input
Requested Term
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Collateral Offered
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Owned By
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MARRIED APPLICANTS MAY APPLY FOR INDIVIDUAL ACCOUNTS, INDICATE BELOW THE TYPE OF CREDIT WANTED
Type of Application
(*)
Individual credit
Joint Credit
Invalid Input
Applicant: Complete for secured credit or if you live in a community property state
Applicant Marital Status
(*)
Married
Separated
Unmarried (Single, Divorced, Widowed)
Invalid Input
APPLICANT
First Name
(*)
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Initial
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Last Name
(*)
Invalid Input
Home Phone
(*)
Invalid Input
Social Security No.
(*)
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Drivers License No & State
(*)
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Birth Date
(*)
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No. of Dependents
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Ages
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Current Street Address
(*)
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Apt. No.
Invalid Input
Years There
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City
(*)
Invalid Input
State
(*)
Invalid Input
Zip Code
(*)
Invalid Input
Former Street Address
Invalid Input
Apt. No.
Invalid Input
Years There
Invalid Input
City
Invalid Input
State
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Zip Code
Invalid Input
EMPLOYMENT AND INCOME
If self employed, attach financial statement and income tax return.
Current Employer
Invalid Input
Hire Date
Invalid Input
Street Address
Invalid Input
City
Invalid Input
State
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Zip
Invalid Input
Phone
Invalid Input
Position
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Monthly Gross Income
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Supervisor's Name & Phone Number
Invalid Input
Former Employer - Name/Address/Phone
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Years There
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OTHER INCOME
You need not list income from alimony, child support, or separate maintenance unless you wish it considered for purposes of granting this credit.
Source of Other Income 1
Invalid Input
Phone
Invalid Input
Monthly Income
Invalid Input
Source of Other Income 2
Invalid Input
Phone
Invalid Input
Monthly Income
Invalid Input
APPLICANT PERSONAL REFERENCES
Nearest Relative Not Living With You
Name/Address/Phone
Relationship
Personal Reference (Not a Relative)
Name/Address/Phone
Known Since
Invalid Input
Invalid Input
Invalid Input
Invalid Input
Invalid Input
Invalid Input
Invalid Input
Invalid Input
ASSETS AND DEPOSITS List all assets
Checking
Financial Institution
Invalid Input
Approx. Balance
Invalid Input
Savings
Financial Institution
Invalid Input
Approx. Balance
Invalid Input
IRA'S
Financial Institution
Invalid Input
Approx. Balance
Invalid Input
Automobiles
Car 1: Year/Make
Invalid Input
Value:
Invalid Input
Car 2: Year/Make
Invalid Input
Value:
Invalid Input
Realestate
Real Estate
Invalid Input
Value:
Invalid Input
Other
Invalid Input
Value:
Invalid Input
CREDIT INFORMATION Be sure to list all open accounts with or without a balance.
Type of Loan
Name of Creditor
Account No
Balance
Monthly Payments
Mortgage or Rent
Invalid Input
Invalid Input
Invalid Input
Invalid Input
Second Mortgage
Invalid Input
Invalid Input
Invalid Input
Invalid Input
Auto Loan
Invalid Input
Invalid Input
Invalid Input
Invalid Input
Credit Card
Invalid Input
Invalid Input
Invalid Input
Invalid Input
Credit Card
Invalid Input
Invalid Input
Invalid Input
Invalid Input
Other
Invalid Input
Invalid Input
Invalid Input
Invalid Input
Other
Invalid Input
Invalid Input
Invalid Input
Invalid Input
Other
Invalid Input
Invalid Input
Invalid Input
Invalid Input
Other
Invalid Input
Invalid Input
Invalid Input
Invalid Input
Other
Invalid Input
Invalid Input
Invalid Input
Invalid Input
Other
Invalid Input
Invalid Input
Invalid Input
Invalid Input
Please answer the following questions. If a yes answer is given, explain on an attached sheet.
Have you ever filed a petition for bankruptcy?
(*)
Yes
No
Invalid Input
If yes, Date:
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Have you ever had any auto, furniture or property repossessed?
(*)
Yes
No
Invalid Input
If yes, Date:
Invalid Input
Are you a co-maker or guarantor of any loan or lease?
(*)
Yes
No
Invalid Input
For Whom?
Invalid Input
Where?
Invalid Input
Do you have any past due bills?
(*)
Yes
No
Invalid Input
Is any income you have listed likely to reduce in the next two years?
Yes
No
Invalid Input
Have you ever had credit in any other name?
Yes
No
Invalid Input
What Name?
Invalid Input
Have you any suits pending, judgements filed, alimony or support awards against you?
Yes
No
Invalid Input
Are you other than a U.S. Citizen or resident alien?
Yes
No
Invalid Input
MARRIED CO-APPLICANTS MAY APPLY FOR INDIVIDUAL ACCOUNTS, INDICATE BELOW THE TYPE OF CREDIT WANTED
CO-APPLICANT ACCOUNT NUMBER
Invalid Input
Co-Applicant: Complete for secured credit or if you live in a community property state
Co-Applicant Marital Status
Married
Separated
Unmarried (Single, Divorced, Widowed)
Invalid Input
CO-APPLICANT
First Name
Invalid Input
Initial
Invalid Input
Last Name
Invalid Input
Home Phone
Invalid Input
Social Security Number
Invalid Input
Drivers License No & State
Invalid Input
Birth Date
Invalid Input
No. of Dependents
Invalid Input
Ages
Invalid Input
Current Street Address
Invalid Input
Apt. No.
Invalid Input
Years There
Invalid Input
City
Invalid Input
State
Invalid Input
Zip Code
Invalid Input
Former Stree Address
Invalid Input
Apt. No.
Invalid Input
Years There
Invalid Input
City
Invalid Input
State
Invalid Input
Zip Code
Invalid Input
CO-APPLICANT EMPLOYMENT AND INCOME If self employed, attach financial statement and income tax return.
Current Employer
Invalid Input
Hire Date
Invalid Input
Street Address
Invalid Input
City
Invalid Input
State
Invalid Input
Zip
Invalid Input
Phone
Invalid Input
Position
Invalid Input
Monthly Gross Income
Invalid Input
Supervisor's Name & Phone Number
Invalid Input
Former Employer - Name/Address/Phone
Invalid Input
Years There
Invalid Input
CO-APPLICANT OTHER INCOME You need not list income from alimony, child support, or separate maintenance unless you wish it considered for purposes of granting this credit.
Source of Other Income 1
Invalid Input
Phone
Invalid Input
Monthly Income
Invalid Input
Source of Other Income 2
Invalid Input
Phone
Invalid Input
Monthly Income
Invalid Input
CO-APPLICANT PERSONAL REFERENCES
Nearest Relative Not Living With You - Name/Address/Phone
Relationship
Personal Reference (Not a Relative) - Name/Address/Phone
Known Since
Invalid Input
Invalid Input
Invalid Input
Invalid Input
Invalid Input
Invalid Input
Invalid Input
Invalid Input
CO-APPLICANT ASSETS AND DEPOSITS List all assets
Checking
Financial Institution
Invalid Input
Approx. Balance
Invalid Input
Savings
Financial Institution
Invalid Input
Approx. Balance
Invalid Input
IRA'S
Financial Institution
Invalid Input
Approx. Balance
Invalid Input
Car 1: Year/Make
Invalid Input
Value:
Invalid Input
Car 2: Year/Make
Invalid Input
Value:
Invalid Input
Real Estate
Invalid Input
Value:
Invalid Input
Other
Invalid Input
Value:
Invalid Input
CREDIT INFORMATION Be sure to list all open accounts with or without a balance.
Type of Loan
Name of Creditor
Account No
Balance
Monthly Payments
Mortgage or Rent
Invalid Input
Invalid Input
Invalid Input
Invalid Input
Second Mortgage
Invalid Input
Invalid Input
Invalid Input
Invalid Input
Auto Loan
Invalid Input
Invalid Input
Invalid Input
Invalid Input
Credit Card
Invalid Input
Invalid Input
Invalid Input
Invalid Input
Credit Card
Invalid Input
Invalid Input
Invalid Input
Invalid Input
Other
Invalid Input
Invalid Input
Invalid Input
Invalid Input
Other
Invalid Input
Invalid Input
Invalid Input
Invalid Input
Other
Invalid Input
Invalid Input
Invalid Input
Invalid Input
Other
Invalid Input
Invalid Input
Invalid Input
Invalid Input
Other
Invalid Input
Invalid Input
Invalid Input
Invalid Input
Other
Invalid Input
Invalid Input
Invalid Input
Invalid Input
Please answer the following questions. If a yes answer is given, explain on an attached sheet.
Have you ever filed a petition for bankruptcy?
Yes
No
Invalid Input
If yes, Date:
Invalid Input
Have you ever had any auto, furniture or property repossessed?
Yes
No
Invalid Input
If yes, Date:
Invalid Input
Are you a co-maker or guarantor of any loan or lease?
Yes
No
Invalid Input
For Whom?
Invalid Input
Where?
Invalid Input
Do you have any past due bills?
Yes
No
Invalid Input
Is any income you have listed likely to reduce in the next two years?
Yes
No
Invalid Input
Have you ever had credit in any other name?
Yes
No
Invalid Input
What Name?
Invalid Input
Have you any suits pending, judgements filed, alimony or support awards against you?
Yes
No
Invalid Input
Are you other than a U.S. Citizen or resident alien?
Yes
No
Invalid Input
You agree that everything stated in this application whether oral, written or through a fax machine, is true and correct to the best of your knowledge. The Credit Union or its agent is authorized to investigate your credit worthiness, employment history, and to obtain a credit report and to answer questions about their credit history with you. You understand that any false or misleading statements in your application may cause any loan to be in default. You agree that this application shall be the Credit Union's property whether or not this Credit Application is approved. You agree to fully insure any collateral offered against loss and damage. You may obtain this insurance through any insurance company of your choice, unless the Credit Union, for good cause, refuses to accept it. NOTICE: Consumer reports (credit reports) may be obtained in connection with this application. If you request, 1) You will be informed whether or not consumer reports were obtained; and 2) If reports were obtained, you will be informed of the names and addresses of the consumer reporting agencies (credit bureaus) that furnished the reports.
Applicant Signature
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Date
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Applicant E-mail:
(*)
Invalid Input
Co-Applicant Signature
Invalid Input
Date
Invalid Input
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