Secure Loan Application
Individual Credit:
You must complete the
Applicant section about yourself and the
Other
section about your spouse if:
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you live in or the property pledged as collateral is located in a community property state
(AZ, CA, ID, LA, NM, NV, TX, WA, WI)
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your spouse will use the account, or
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you are relying on your spouse's income as a basis for repayment. If you are relying
on income from alimony, child support, or separate maintenance, complete the Other section
to the extent possible about the person on whose payments you are relying.
Joint Credit: If you are applying with another person, complete the
Applicant and
Other
sections.
Guarantor: Complete the
Other section if you are a guarantor on an account/loan.
Check below to indicate the type of account(s) and
type of credit for which you are applying.
Married Applicants may apply for a separate account.
(Including ATM/Debit Card Access to the Account if Available)
Months
Applicant |
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$
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% |
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Employment/Income
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Notice: Alimony, child support, or separate maintenance income need not be revealed if you
do not choose to have it considered. |
Employment Income
$
per
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Other Income
$
per
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First Name
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MI
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Last Name
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Mother's Maiden Name
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Account #
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SSN
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Driver's License Number/State
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Birth Date *
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Home Phone *
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Business Phone/Ext
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Present Address
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Own
Rent
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City
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State
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Zip
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Years At This Address
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Mortgage/Rent Owed To:
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Mortgage Balance
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Monthly Payment
$
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Interest Rate
% |
Married
Separated
Unmarried (Single - Divorce - Widowed)
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Employment/Income |
Employer Name *
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Employer Address *
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Employment Start Date
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Notice: Alimony, child support, or separate maintenance income need not be revealed if you do not choose to have it considered. |
Employment Income
$ *
Income Dollar Amount per
Income Rate
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Other Income
$
Other Dollar Amount per
Other Dollar Rate
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Net
Gross
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Source
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State Law Notices |
OHIO RESIDENTS ONLY: The Ohio laws discrimination require that all creditors make credit
equally available to all credit worthy customers, and that credit reporting agencies
maintain separate credit histories on each individual upon request. The Ohio Civil
Rights Commission administrators compliance with this law.
WISCONSIN RESIDENTS ONLY:(1)No provision of any marital properly agreement unilateral statement
under Section 766.59, or court degree under Section 766.70 will adversely affect the
rights of the Credit Union unless the Credit Union is Furnished a copy of the agreement,
statement or degree, or has actual knowledge of its terms, before the credit is granted
or the account is opened. (2)Please sign if you are not applying for this account
or loan with your spouse. The credit being applied for, if granted, will be incurred
in the interest of the marriage or family of the undersigned.
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Signature(s) |
You agree that everything you have stated in this application is correct to the best of
your knowledge. If there are any important changes you will notify us in writing
immediately. You authorize the Credit Union to obtain credit reports in connection
with this application for credit and for any update, increase, renewal, extension, or
collection of the credit received. You understand that the Credit Union will rely
on the information in this application and your credit report to make its decision.
If you request, the Credit Union will tell you the name and address of any credit bureau
from which it received a credit report on you. It is a federal crime to willfully
and deliberately provide incomplete or incorrect information on loan applications made
to federal credit unions or state chartered credit unions insured by NCUA.
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(Click Once Only)
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