Joint Credit Application

Fields marked * are required

Email Address*

Type of Loan*

Loan Amount* Requested Terms in Months

Purpose of Loan*

APPLICANT

Credit Union Account Number

First Name* Middle Initial Last Name*.

DOB* SSN* Drivers License Number*

Provide your marital status only if this loan request is for secured credit or if you reside in one of the following community property states: AZ, CA, ID, LA, NM, NV, TX, WA, WI. If neither of the preceding conditions apply, select No Answer to Marital Status.

Marital Status No. of Dependants Ages

Daytime Phone Number* Evening Phone Number

Work Phone Number Cell Phone Number*

Address:* City State ZIP

Rent/Own: Monthly Payment

Years at this address

Previous Address

Complete this section only if you have not been at your current address for more than 2 years.

Address City State ZIP

Years at this address

Because you live in a community property state, include your spouse.

Employment

Your Work Title:

Name of Employer: Supervisor Name:

Address City State ZIP

Years At This Job* Gross Monthly Salary *

Pay Frequency *

Previous Employment

Complete this section only if you have worked less than 2 years at your current employer. Click "Add Previous Employment" to enter additional previous employment information.

Name of Employer:

Address City State ZIP

Years At This Job*

Other Income

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

Other Income - Source: Other Income - Amount:

Other Gross Income - Frequency:

Outstanding Debt

Provide your outstanding debt information below.

Creditor 1: Current Balance : Monthly Pmt :

Creditor 2: Current Balance : Monthly Pmt :

Creditor 3: Current Balance : Monthly Pmt :

Creditor 4: Current Balance : Monthly Pmt :

References

Provide two references. Please do not use relatives living at your address.

Reference Name: Relationship to Member :

Address City State ZIP

Reference Day Phone

Reference Name2: Relationship to Member :

Address City State ZIP

Reference2 Day Phone

CO-APPLICANT


Credit Union Account Number

Relationship to Applicant

First Name Middle Initial Last Name.

DOB SSN Drivers License Number

Daytime Phone Number Evening Phone Number

Work Phone Number Cell Phone Number

Address City State ZIP

Year at this address

Previous Address

Complete this section only if you have not been at your current address for more than 2 years.

Address City State ZIP

Years at this address

Because you live in a community property state, include your spouse.

Employment

Your Work Title:

Name of Employer: Supervisor Name:

Address City State ZIP

Years At This Job* Gross Monthly Salary *

Pay Frequency *

Previous Employment

Complete this section only if you have worked less than 2 years at your current employer. Click "Add Previous Employment" to enter additional previous employment information.

Name of Employer:

Address City State ZIP

Years At This Job*

Other Income

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

Other Income - Source: Other Income - Amount:

Other Gross Income - Frequency:

 

Outstanding Debt

Provide your outstanding debt information below.

Creditor 1: Current Balance : Monthly Pmt :

Creditor 2: Current Balance : Monthly Pmt :

Creditor 3: Current Balance : Monthly Pmt :

Creditor 4: Current Balance : Monthly Pmt :

References

Provide two references. Please do not use relatives living at your address.

Reference Name:* Relationship to Member :

Address* City* State* ZIP*

Reference Day Phone*

Reference Name2:* Relationship to Member :

Address* City* State* ZIP*

Reference2 Day Phone*

Questions
Do you have any outstanding judgments?*



Have you ever filed for bankruptcy or had a debt adjustment plan confirmed under Chapter 13?*  No Yes
Have you had property foreclosed upon or repossessed in the last 7 years?*  No Yes
Are you a party in a lawsuit?  No Yes
Are you other than a U.S. Citizen or permanent resident alien?*  No Yes
Is your income likely to decline in the next two years?*  No Yes
Are you a co-maker, co-signer or guarantor on any loan not listed above?*  No Yes
For whom? (Name of others Obligated on Loan)
To whom? (Name of creditor)

 

 

NOTICE TO WISCONSIN RESIDENTS: No provision of any marital property agreement, unilateral statement under S.766.59, or court decree under S.766.70 will adversely affect the rights of the credit union unless the credit union is furnished a copy of the agreement, statement or decree, or has actual knowledge of its terms, before the credit is granted or the account is opened.
OHIO RESIDENTS ONLY: The Ohio laws against discrimination require that all creditors make credit equally available to all creditworthy customers, and that credit reporting agencies maintain separate credit histories on each individual upon request. The Ohio Civil Rights Commission administers compliance with this law.

 

REVIEW YOUR APPLICATION.

Review all of your answers carefully.It is a federal crime to willfully and deliberately provide incorrect information on loan applications made to federal credit unions or state chartered credit unions insured by NCUA. 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.

By submitting this application, 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.

 

 


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