Loan Application

*Required Information


example: College Tuition
example: $5,000
Name *
Name
Name CO-Applicant
Name CO-Applicant
Date of Birth *
Date of Birth
Date of Birth CO-Applicant
Date of Birth CO-Applicant
Phone *
Phone
Phone CO-Applicant
Phone CO-Applicant
Physical Address *
Physical Address
Physical Address CO-Applicant
Physical Address CO-Applicant
Do You:
Do You: CO-Applicant
$1,500 a month or $200 a week, etc...
$1,500 a month or $200 a week, etc...
Employer Address
Employer Address
Employer Address CO-Applicant
Employer Address CO-Applicant
Are you a U.S. Citizen or permanent resident alien? *
Have you ever filed for bankruptcy protection? *
Is your income likely to decline in the next two years? *
By selecting this box, I agree to the terms stated below. *

BY SUBMITTING THIS APPLICATION YOU AFFIRM THE FOLLOWING:

THE INFORMATION YOU HAVE STATED IN THIS APPLICATION IS CORRECT TO THE BEST OF YOUR KNOWLEDGE;

YOU AUTHORIZE THE CREDIT UNION TO OBTAIN A COPY OF YOUR CREDIT REPORT AND VERIFY YOUR EMPLOYMENT;

THE CREDIT UNION WILL RELY ON THE INFORMATION IN THIS APPLICATION AND YOUR CREDIT REPORT TO MAKE ITS DECISION;

IT IS A CRIME TO WILLFULLY AND DELIBERATELY PROVIDE INCOMPLETE OR INCORRECT INFORMATION ON THIS APPLICATION.