Consumer Loan Application


* indicates a required field


You promise that everything you state 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. If there is a joint applicant on the loan, that joint applicant has authorized the submission of the application. 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.

* Selecting "I Decline" will not allow you to submit your application


Loan Information

*Loan Purpose:

Collateral

Do you have information about the collateral that will secure this loan?
Comments:
*Loan Amount Requested:
*Term: (In number of months)
Would you like a lending representative to follow up with you?

Borrower Information

*Is this an individual or joint application?
*Account Number:
*First Name:
Middle Name:
*Last Name:
Suffix:
*Date of Birth:
*SSN:
*Physical Address Line 1:
Physical Address Line 2:
*Physical City, State Zip Code: ,
*Is Your Mailing Address Different From Your Physical Address?
Mailing Address Line 1:
Mailing Address Line 2:
Mailing City, State Zip Code: ,
*Residential Status:
*Monthly House Payments:
*Best Contact:
Home Phone:
Alternate Phone:
Email Address:

Borrower Employment Information

*Employment Status: Other status:
*Salary (Annual Gross):
*Title/Position:
*Employer Name:
*Business Phone:
*Time With Present Employer: years months

Other Income for Borrower: (Annual Gross):

Amount Source Employer Name

Co-Borrower

*First Name:
*Last Name:
*Date of Birth:
*SSN:
*Physical Address Line 1:
Physical Address Line 2:
*Physical City, State Zip Code: ,
Best Contact:
Home Phone:
Alternate Phone:
Email Address:
*Salary (Annual Gross)::

* indicates a required field