| Individual Credit: You must complete the Applicant section about yourself and the other section about your spouse if: 1. You live in a community property state (AK, AZ, CA, ID, LA, NM, NV, P.R., TX, WA, WI). 2. your spouse will use the account, or 3. you are relying on your spouse’s income as a source of 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 for a joint account or an account that you and another person will use, you must complete the applicant and Spouse Co-Applicant section Check here if you intend to apply for Joint Credit. |
| Date | Stoc/Vin | Request Amount | ||
| APPLICANT INFORMATION | ||||
| Name: | Birth date: | Driver’s License:
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| Social Security No.: | ||||
| Current Address: | How Long at Address:
Housing Cost:
Home Phone:
Cell Phone:
E-Mail Address:
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Previous Address:
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Current Employer |
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| Name | Work Phone | Position | ||
| Employment Income | How Long at Position | |||
| Previous Employer | ||||
| Name | Work Phone | Position | ||
| Employment Income | How Long at Position | |||
| Other Income Employment Income | Other Income/Source: |
| SPOUSE OR CO-APPLICANT INFORMATION | ||||
| Name: | Birth date: | Driver’s License: | ||
| Social Security No.: | ||||
| Current Address: | How Long at Address:
Housing Cost:
Home Phone:
Cell Phone:
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Previous Address:
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Current Employer |
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| Name | Work Phone | Position | ||
| Employment Income | How Long at Position | |||
| Previous Employer | ||||
| Name | Work Phone | Position | ||
| Employment Income | How Long at Position | |||
| Other Income Employment Income | Other Income/Source: |
The terms “I”, “ME”, and “MINE” in this Application mean each of those signing below. You promise that the information stated in this Consumer Loan Application is true and correct to the best of your knowledge. The Credit Union or its agent is authorized to investigate your credit worthiness, employment history, and to obtain a credit report and to answer questions about its credit history with you. The Credit Union may also obtain credit reports to update, increase, extend or renew credit with you. False or misleading statements in your application may cause any loan to be in default. You agree that this application shall be the Credit Union’s property whether or not this application is approved. You will notify the Credit Union in writing immediately of any changes in your name, address or employment. You understand that it is a crime to willfully and deliberately provide incomplete or incorrect information to obtain credit. If you request, you will be provided the name and address of any credit bureau form which we received a credit report.
Please type date in the boxes below.
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