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Loan Application

Loan Information

Applicant Information

Debts

References & Agreement

What kind of Loan are you looking for?

Loan Type *

Loan Amount *

Payment Method *

Application Type *

Individual Joint

Application Type is required
Tell us about you

First Name *

Last Name *

Date of Birth *

Account Number

Social Security Number *

Driver's License Number

Drivers License State

Home Phone *

Work Phone *

Cell Phone *

Email

Preferred Contact Method *

Address *

Address Line 2

City *

State *

Zip *

Housing Type*

Years and Months at address *

Mortgage Holder or Landlord Name

Monthly rent or board

Mortgage Balance

Mortgage Payment

If less than 2 years at current address:

Previous Address

Previous Address Line 2

Previous City

Previous State

Previous Zip

Employment Information

Self Employed *

Yes No

Whether you are Self Employed is required

Job Title

Employer Name *

Employer Address *

Employer City *

Employer State *

Employer Zip

Years and months at job

Gross salary per pay period

Pay frequency*

If employed for less than 2 years at your current job:

Previous Employer Name

Previous Employer Address

Previous Employer City

Previous Employer State

Previous Employer Zip

Previous Years and months at job

Additional Income

Additional Income

Other Income Source

Additional Income Gross Monthly Amount

Pay frequency

Military Service

Are you currently in the military? *
Yes No
Are you currently in the military? is required

Is duty station transfer expected during the next year? *
Yes No
Is duty station transfer expected during the next year? is required

Where?

Ending/Separation Date

Joint Applicant Information

First Name *

Last Name *

Date of Birth *

Account Number

Social Security Number *

Driver's License Number

Drivers License State

Home Phone *

Work Phone *

Cell Phone *

Email

Preferred Contact Method *

Address *

Address Line 2

City *

State *

Zip *

Housing Type*

Years and Months at address *

Mortgage Holder or Landlord Name

Monthly rent or board

Mortgage Balance

Mortgage Payment

If less than 2 years at current address:

Previous Address

Previous Address Line 2

Previous City

Previous State

Previous Zip

Employment Information

Self Employed *

Yes No

Whether Joint Applicant is Self Employed is required

Job Title

Employer Name *

Employer Address *

Employer City *

Employer State *

Employer Zip *

Years and months at job

Gross salary per pay period

Pay frequency*

If employed for less than 2 years at your current job:

Previous Employer Name

Previous Employer Address

Previous Employer City

Previous Employer State

Previous Employer Zip

Previous Years and months at job

Additional Income

Additional Income

Other Income Source

Additional Income Gross Monthly Amount

Pay frequency

Military Service

Are you currently in the military? *
Yes No
Are you currently in the military? is required

Is duty station transfer expected during the next year? *
Yes No
Is duty station transfer expected during the next year? is required

Where?

Ending/Separation Date
Debts

Creditor Name

Liability Type

Account Number

Loan Balance

Monthly Payment

Additional Outstanding Debts

Creditor Name

Liability Type

Account Number

Loan Balance

Monthly Payment

Property Owned

Home

Date Purchased

Purchase Price

Current Market Value

In whose name

Automobile 1

Year, Make & Model

Financed By

Balance Owning

Monthly Payment

Automobile 2

Year, Make & Model

Financed By

Balance Owing

Monthly Payment
References & Agreement

Type of Reference *

Reference Name *

Reference Address *

Reference Address Line 2

Reference City

Reference State *

Reference Zip *

Reference Phone *

Do you have any outstanding judgments? *

Yes No

Whether you have outstanding judgments is required

Have you ever filed for bankruptcy or had a debt adjustment plan confirmed under Chapter 13?*

Yes No

Chapter 13 Status is required

Have you had property foreclosed upon or repossessed in the last 7 years?*

Yes No

Whether your property has been foreclosed is required

Are you a U.S. Citizen or permanent resident alien? *

Yes No

Citizenship Status is required

Is your income likely to decline in the next two years? *

Yes No

Whether your income is likely to decline is required

Are you a co-maker, co-signer or guarantor on any loan not listed above? *

Yes No

Co-Maker Status is required

If yes, what is the monthly payment *

Are you liable for alimony, child support or maintenance programs? *

Yes No

Child Support Status is required

If yes, what is the monthly payment *

Please upload a valid form of identification to verify your identity *

Accepted formats: .pages, .doc, .docx, .pdf, .png, .jpg

Select files from your computer
or simply drag & drop them here

You promise that everything you have stated in this application is correct to the best of your knowledge and that the above information is complete listing of what you owe. 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 ay credit bureau from which it received a credit report on you. It is a crime to willfully and deliberately provide incomplete or incorrect information in this application.

Primary Applicant Date *

Joint Applicant Date *

Savings Information

Checking Information

Vehicle Loan Information

VISA Card Information

Savings Information

Checking Information

Savings Information

Checking Information