Loan Application

Loan Request Information:
Email:
Amount of Loan: $
Purpose of Loan:
Method of Repayment: Cash/Check  
Payroll Deduction  
Transfer
Requested Term of the Loan: 
 
Applicant Information:

If you are not currently a member, please enter account # 111222333
Member Account Number:
Social Security Number:
Date of Birth:
Full Name:
Residential Street Address: Street: Apt:
City:
State:
Zip:
Do You: Own Rent Other
How long have you lived at this address? Years Months
Monthly rent or mortgage payment? $
Home Phone Number:
Work Phone Number:
Number of Dependents:
Marital Status: Complete Marital Status if this loan is for:
A:  Joint or secured credit, or
B.  You reside in or rely on property in a Community Property State (AZ, CA, ID, LA, NM, NV, TX, WA, WI)		 Married 

Unmarried

Separated
Previous Address (if at current address less than 2 years): Street: Apt:
City:
State:
Zip:
Employment Information:
Name of Employer:
Employer's Address:
City:
State:
Zip:
Gross Monthly Salary: $
Length of Employment: Years Months
Position or Job Title:
Please list any 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. Include the source and the monthly dollar amount:
Credit Obligations:
Please list all credit obligations you currently have:
    Balance     Monthly Payment
    Balance     Monthly Payment
    Balance     Monthly Payment
    Balance     Monthly Payment
    Balance     Monthly Payment
Co-Applicant Information:
Complete this section only for: (i) joint credit; (ii) with spousal information if your spouse will use or be liable on the account, you will rely on your spouse's income to pay the debt or if you reside in a community property state.
Co-applicant's Name:
Co-applicant's Social Security Number:
Your relationship to Co-applicant:
Name of Employer:
Employer's Address:
City:
State:
Zip:
Gross Monthly Salary: $
Length of Employment: Years Months
Position or Job Title:
General Questions:
Have you ever obtained credit under another name? Yes No
Have you ever filed for bankruptcy or had a repossession? Yes No
Are you a comaker, endorser, or guarantor on any loan or note? Yes No
Are there any judgements or liens against you? Yes No
Do you have any past due bills? Yes No
If you answered Yes to any of the above questions,please provide an explanation:

 

 

 

 

We do business in Accordance with the Federal Fair Housing Law and the Equal Credit Opportunity Act

 
By submitting this application you are authorizing us to obtain credit reports and make any inquiries we consider appropriate for this application and to tell others about our credit experience with you.

Special Note: Verification of income and other supporting documentation may be required to complete the processing of this loan application.