Loan Application

* Indicates Required

• What kind of Loan are you looking for?

  Loan Type *

  Personal Loan New Car Used Car Auto Refinance Share Secured VISA Credit Card Fast Funds Holiday Helper

  Loan Amount *

  Payment Method *

  Coupon Book Payroll Deduction Monthly Transfer

  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

  Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming

  Home Phone *

  Work Phone *

  Cell Phone *

  Email

  Preferred Contact Method *

  Work Home Cell Email

  Address *

  Address Line 2

  City *

  State *

  Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming

  Zip *

  Housing Type*

  Own Rent Live with parents

  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

  Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming

  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 *

  Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming

  Employer Zip *

  Years and months at job *

  Gross salary per pay period

  Pay frequency*

  Monthly Bi-weekly Weekly Semi-monthly

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

  Previous Employer Name

  Previous Employer Address

  Previous Employer City

  Previous Employer State

  Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming

  Previous Employer Zip

  Previous Years and months at job

  Additional Income

  Additional Income

  Other Income Source

  Overtime Parttime Rental income Alimony Child Support Maintenance

  Additional Income Gross Monthly Amount

  Pay frequency

  Monthly Bi-weekly Weekly Semi-monthly

  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

  Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming

  Home Phone *

  Work Phone *

  Cell Phone *

  Email

  Preferred Contact Method *

  Work Home Cell Email

  Address *

  Address Line 2

  City *

  State *

  Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming

  Zip *

  Housing Type*

  Own Rent Live with parents

  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

  Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming

  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 *

  Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming

  Employer Zip *

  Years and months at job *

  Gross salary per pay period

  Pay frequency*

  Monthly Bi-weekly Weekly Semi-monthly

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

  Previous Employer Name

  Previous Employer Address

  Previous Employer City

  Previous Employer State

  Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming

  Previous Employer Zip

  Previous Years and months at job

  Additional Income

  Additional Income

  Other Income Source

  Overtime Parttime Rental income Alimony Child Support Maintenance

  Additional Income Gross Monthly Amount

  Pay frequency

  Monthly Bi-weekly Weekly Semi-monthly

  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 *

  Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming

  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.

  I acknowledge that there is a $20.00 fee to apply for a Fast Funds loan. *

  Acknowledgement is required

  Primary Applicant Date *

  Joint Applicant Date *