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?* |
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| 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) |
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| To whom? (Name of creditor) |
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| 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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