Consumer Loan Application

Required fields are marked with an asterisk *

Demo Financial Institution

A. Individual Credit: You must complete the Applicant section about yourself and the Other section about your spouse if:
1. you live in or the property pledged as collateral is located in a community property state (AK, AZ, CA, ID, LA, NM, NV, TX, WA, WI),
2. your spouse will use the account, or
3. you are relying on your spouse's income as basis for 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.

B. Joint Credit: Each Applicant must individually complete the appropriate section below.  If the Co-Borrower is spouse of the Applicant, mark the Co-Applicant box.

C. Guarantor: Complete the Other section if you are a guarantor on an account/loan.

* (Married Applicants may apply for a separate account.)

Amount Requested ($)*

Purpose/Collateral*

Repayment Method:*

Payment Protection

The credit union will disclose the cost of this voluntary insurance to you. A separate insurance election which discloses the terms and conditions must be signed for coverage to become effective.

Are you interested in having your loan protected?

Applicant

Last Name*

First Name*

MI*

Birth Date*

Social Security Number*

Driver License Number*

Account Number

List ages of dependents not listed by Other applicant (exclude self)

Home Phone*

Business Phone

Email Address

Present Street Address*

City*

State*

ZIP*

Own/Rent*

Years at this address*

Previous Street Address

City

State

ZIP

Own/Rent

Years at this address:

Marital Status:

Employment/Income

Notice: Alimony, child support, or separate maintenance income need not be revealed if you do not choose to have it considered.

Employment Income ($/period)*

Other Income ($/period)
Source:

Employer Name*

Street Address*

City*

State*

ZIP*

Title/Grade*

Start Date*

Hours/Week*

Supervisor's Name

If self-employed, type of business

Military: Is duty station transfer expected during the next year?

Ending/separation date:

Previous Employer (if employed fewer than five years)

Employer Name

Street Address

City

State

ZIP

Start Date

End Date

Reference (nearest relative not living with you)

Reference Name

Street Address

City

State

ZIP

Relationship

Home Phone

Last Name*

First Name*

MI*

Birth Date*

Social Security Number*

Driver License Number*

Account Number

List ages of dependents not listed by Applicant (exclude self)

Home Phone*

Business Phone

Email Address

Present Street Address*

City*

State*

ZIP*

Own/Rent*

Years at this address*

Previous Street Address

City

State

ZIP

Own/Rent

Years at this address:

Marital Status:

Employment/Income

Notice: Alimony, child support, or separate maintenance income need not be revealed if you do not choose to have it considered.

Employment Income ($/period)*

Other Income ($/period)
Source:

Employer Name*

Street Address*

City*

State*

ZIP*

Title/Grade*

Start Date*

Hours/Week*

Supervisor's Name

If self-employed, type of business

Military: Is duty station transfer expected during the next year?

Ending/separation date:

Previous Employer (if employed fewer than five years)

Employer Name

Street Address

City

State

ZIP

Start Date

End Date

Reference (nearest relative not living with you)

Reference Name

Street Address

City

State

ZIP

Relationship

Home Phone

What You Owe Creditor name other than this credit union Interest
rate		 Present
balance		 Monthly
payment		 Owed by
Description Applicant Other

List any names under which your credit references and credit history can be checked.

What You Own Location of property or financial institution Market
value		 Pledged as collateral
for another loan		 Owned by
Description Yes No Applicant Other
Other Information About You Applicant Other
Yes No Yes No

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

2. Do you currently have any outstanding judgments 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?*

If yes, explain.

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

If yes, explain.

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

For whom? (name others obligated on loan)

To whom? (name creditor)

Signatures

*You promise that everything you have stated in this application is correct 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 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 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.