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Loan Application

  [ Printable Loan Application ]


How to Apply
Complete all information. Incomplete applications will delay processing.

Fax proof of all income (2 pay stubs, rental income, child support, social security) to 508-222-9359

Optional insurance to cover balance of loan in the event of death or disability is available. Contact the credit union during business hours for quotes.

Repayment
Type of Application
Individual    Joint
Purpose of loan
Amount Requesting
Name
Mother's Maiden Name
Account Number
Social Security
- -
Drivers License Number
Number of Dependants
(Exclude Self)
Birthday
- -
Home Phone #
- -
Work Phone #
- -
Email Address
Address
Own or Rent
Own    Rent
Years There
Your Employer's Name

Employer's address

Occupation
Start Date
Gross Income
per
Week    Month    Year
# of hours worked per week
Other income
per
Week    Month    Year
Source
Nearest relative not living with you?
Relationship
Home Phone

Co-Applicant - If Applicable
Name
Mother's Maiden Name
Account Number
Social Security
- -
Drivers License Number
Number of Dependants
(Exclude Self)
Birthday
- -
Home Phone #
- -
Work Phone #
- -
Email Address
Address
Your Employer's Name

Employer's address

Occupation
Start Date
Gross Income
per
Week    Month    Year
# of hours worked per week
Other income
per
Week    Month    Year
Source

Nearest relative not living with you?
 
Relationship
Home Phone

What You Owe Creditor Name Other Than This Credit Union Monthly Payment Owed By  
Applicant Other
Rent or
First Mortgage
2nd Mortgage
1st Auto Loan
2nd Auto Loan
Child Care
Child Support
Credit Card
Credit Card
Other
Other

Other Infomation About You Applicant
 Other
Yes No Yes No
Are you a U.S. Citizen or Permanent Resident Alien?
Do you currently have any outstanding judgements or have you ever filed for bankruptcy, had a debt adjustment plan confirmed under chapter 13, had property foreclosed upon or repossessed in the last 7 years, or been a party in a lawsuit?
Is your income likely to decline in the new two years?
Are you a co-maker, co-signer, or guarantor on any loan not listed above?

For whom (Name of others obligated on loans) To whom (Name of creditor)
You promise that everything you have stated in this application is coorect to the best of your knowledge and that the above information is a complete listing of what you owe. If there are any important changes you will notify us in writing immediatey. 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 any credit bureau from which it recieved a credit report on you. It is a federal crime to will fully and deliberately provide incomplete or incorrect information on loan applications made to federal credit union or state chartered credit unions insured by NCUA.

Do you agree with these conditions? Applicant
yes      no
Do you agree with these conditions? Co Applicant (If Applicable)
yes      no

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