Loan Application

Married Applicants: May apply for a separate account. 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 a 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.

Joint Credit: Each Applicant must individually complete the appropriate section below. If Co-Borrower is spouse of the Applicant, mark the Co-Applicant box. Guarantor: Complete the Other section if you are a guarantor on an account/loan.

Please note that there is a $10.00 application fee on all loan applications.
Type of Loan
Repayment Option: *
Payment Protection
Are you interested in having your loan protected?
If you answer "yes", the credit union will disclose the cost to protect your loan. The protection is voluntary and does not affect your loan approval. In order for your loan to be covered, you will need to sign a separate application that explains the terms and conditions.
Applicant
Birth Date *
Birth Date
Home Phone
Home Phone
Cell Phone
Cell Phone
Business Phone & Ext.
Business Phone & Ext.
Present Address *
Present Address
Do you own or rent the above residential address? *
Previous Address
Previous Address
Complete for joint credit, secured credit or if you live in a community
Start Date
Start Date
Notice
Alimony, child support, or separate maintenance income need not be revealed if you do not choose to have it considered.
Type
Military
IS DUTY STATION TRANSFER EXPECTED DURING NEXT YEAR?
Ending/Separation Date
Ending/Separation Date
Starting Date
Starting Date
Ending Date
Ending Date
Reference
Home Phone Number *
Home Phone Number
Other Applicant
Birthdate
Birthdate
Home Phone Number
Home Phone Number
Cell Phone Number
Cell Phone Number
Business Phone Number & Ext.
Business Phone Number & Ext.
Present Address (Street - City - Zip)
Present Address (Street - City - Zip)
Do you own or rent the above residential address?
Previous Address (Street - City - Zip)
Previous Address (Street - City - Zip)
Marital Status
Complete for joint credit, secured credit or if you live in a community property state:
Start Date
Start Date
Notice
Alimony, child support, or separate maintenance income need not be revealed if you do not choose to have it considered.
Type
Military
IS DUTY STATION TRANSFER EXPECTED DURING NEXT YEAR?
Starting Date
Starting Date
Ending Date/Separation Date
Ending Date/Separation Date
Starting Date
Starting Date
Ending Date
Ending Date
Reference for other applicant
Home Phone Number
Home Phone Number
What you owe
For this section, include in order what you owe, creditor name other than this credit union, interest rate, present balance, monthly payment, and who it is owned by (either applicant, other, or both). Include as many as needed. Example: 1. 2017 Mustang, Bank of America, 3.5%, $15,000, $450, owned by applicant 2. Home, Wells Fargo, 5.6%, $250,000, $900, owned by applicant and other.
What you own
In this section, include in order what you own, location of property of financial institution, market value, whether or not it was used as collateral for another loan, and if it is owned by applicant, other, or both. Example 1. 1995 Mazda, Chase Bank, $10,000, not pledged as collateral, owned by other 2. Boat, applicant's address, $30,000, pledged as collateral for another loan, owned by applicant
Other information about you
Are you a U.S. citizen or permanent resident alien? *
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? *
Is your income likely to decline in the next two years?
Are you a co-maker, co-signer or guarantor on any loan not listed above? *
(Name of Others Obligated on Loan):
TO WHOM (Name of Creditor):
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. WISCONSIN RESIDENTS ONLY: (1) No provision of any marital property agreement, unilateral statement under Section 766.59, or court decree under Section 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. (2) Please sign if you are not applying for this account or loan with your spouse. The credit being applied for, if granted, will be incurred in the interest of the marriage or family of the undersigned.
Date
Date
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 crime to willfully and deliberately provide incomplete or incorrect information in this application. By printing and submitting my name in the box below, I/we agree to the terms and conditions of the Membership and Account Agreement, Truth-in-Savings Disclosure, Privacy Disclosure, Funds Availability Policy Disclosure, if applicable, and to any amendment the Credit Union makes from time to time which are incorporated herein. I/We acknowledge receipt of the agreements and disclosures applicable to the accounts and services requested herein. If an access card or EFT service is requested and provided, I/we agree to the terms of and acknowledge receipt of the Electronic Fund Transfers Agreement and Disclosure. All of the terms, conditions, form of account ownership, account selection and other information indicated on this document applies to all of the accounts listed unless the credit union is notified in writing of a change. I/We agree that any updates identified herein amend the previously signed Member Services Request(s), and are subject to the terms and conditions of the applicable disclosures noted above. The Internal Revenue Service does not require your consent to any provision of this document other than the certifications required to avoid backup withholding.
Date *
Date
Date
Date