Untitled Document

Loan Application

Applicant Information

Account Number (Existing Member)
*Amount Requested
*Purpose of Loan Collateral Offered
*First Name *Middle *Last Name
*Date of Birth (MM/DD/YYYY) *Social Security
*Driver's License Number *State
Number of Dependents List Ages of Dependents
E-mail Address

Present Home Address

*Address Line 1 Line 2
*City *State *Zip
*Own or Rent Own Rent Live w/Family
*Monthly Mortgage/Rent Amount *Years There
*Home Phone Number ( ) *Cell ( )

Employment Information

*Employer Name *Monthly Gross Income
*Start Date (MM/DD/YYYY) Work Phone Number ( )
Previous Employer (If current employment less than 2 years)

Additional Income

Additional Income Type
Additional Amount Frequency

Deposits at other Financial Institutions (If none please put "none" in the first box)

*Financial Institution Name Account # Checking Savings
Financial Institution Name Account # Checking Savings
Financial Institution Name Account # Checking Savings
Financial Institution Name Account # Checking Savings

Clear Title Assets (Car/Property) (If none please put "none" in the first box)

*Asset Value
Currently Pledged as Collateral: Yes No
Asset Value
Currently Pledged as Collateral: Yes No

Outstanding Debts and Other Obligations (If none please put "none" in the first box)

*Creditor Balance Monthly Payments
Creditor Balance Monthly Payments
Creditor Balance Monthly Payments
Creditor Balance Monthly Payments
Creditor Balance Monthly Payments
Creditor Balance Monthly Payments
Creditor Balance Monthly Payments
Creditor Balance Monthly Payments

Additional Information

*Any Outstanding Judgements?   Yes No
*Bankruptcy Filed?   Yes No
If yes to bankruptcy:   Personal Business
If yes to bankruptcy:   Chapter 7 Chapter 13
*Is income likely to decline in the next 2 years?   Yes No
*Are you a co-maker or co-signer on other loans?   Yes No
*Any past due bills?   Yes No
*Are you a permanent or non-resident alien?   Yes No
*Any repossessed collateral?   Yes No
*Are you a party in a lawsuit?   Yes No

References

*Name *Relationship
*Address *Phone Number ( )
*Name *Relationship
*Address *Phone Number ( )
*Name *Relationship
*Address *Phone Number ( )

Co-Applicant Information

Account Number (Existing Member)
First Name Middle Last Name
Date of Birth (MM/DD/YYYY) Social Security
Driver's License Number State
Number of Dependents List Ages of Dependents
E-mail Address

Present Home Address

Address Line 1 Line 2
City State Zip
Own or Rent Own Rent Live w/Family
Monthly Mortgage/Rent Amount Years There
Home Phone Number ( ) Cell ( )

Employment Information

Employer Name Monthly Gross Income
Start Date (MM/DD/YYYY) Work Phone Number ( )
Previous Employer (If current employment less than 2 years)

Additional Income

Additional Income Type
Additional Amount Frequency

Additional Information

Any Outstanding Judgements?   Yes No
Bankruptcy Filed?   Yes No
If yes to bankruptcy:   Personal Business
If yes to bankruptcy:   Chapter 7 Chapter 13
Is income likely to decline in the next 2 years?   Yes No
Are you a co-maker or co-signer on other loans?   Yes No
Any past due bills?   Yes No
Are you a permanent or non-resident alien?   Yes No
Any repossessed collateral?   Yes No
Are you a party in a lawsuit?   Yes No

References

Name Relationship
Address Phone Number ( )
Name Relationship
Address Phone Number ( )
Name Relationship
Address Phone Number ( )

Deposits at other Financial Institutions (If none please put "none" in the first box)

Financial Institution Name Account # Checking Savings
Financial Institution Name Account # Checking Savings
Financial Institution Name Account # Checking Savings
Financial Institution Name Account # Checking Savings

Clear Title Assets (Car/Property) (If none please put "none" in the first box)

Asset Value
Currently Pledged as Collateral: Yes No
Asset Value
Currently Pledged as Collateral: Yes No

Outstanding Debts and Other Obligations (If none please put "none" in the first box)

Creditor Balance Monthly Payments
Creditor Balance Monthly Payments
Creditor Balance Monthly Payments
Creditor Balance Monthly Payments
Creditor Balance Monthly Payments
Creditor Balance Monthly Payments
Creditor Balance Monthly Payments
Creditor Balance Monthly Payments
 

By clicking the submit button below I understand and agree to the following:

The Local Federal Credit Union will require information pertaining to my credit worthiness and I agree that the credit union shall be allowed to consult whomever it deems necessary for that purpose and I hereby release them from all liability therefore. I hereby certify that the foregoing statements are made for the purpose of obtaining a loan and are true, complete and correct to the best of my knowledge and belief. I also agree and attest that my name and address shown herein is my legal name and the place of my residence, and such address is the proper address for all notice(s) required by this agreement, and I further understand that any changes in this address must be submitted to us in writing to be effective.

You promise that the information stated in this Loan Application is true and correct to the best of your knowledge. The Credit Union or its agent is authorized to investigate your credit worthiness, employment history, and to obtain a credit report and to answer questions about its credit history with you. The Credit Union may also obtain credit reports to update, increase, extend or renew credit with you. False or misleading statements in your application may cause any loan to be in default. You agree that this application shall be the Credit Union's property whether or not this application is approved. You will notify the Credit Union in writing immediately of any changes in your name, address or employment. You understand that it is a crime to willfully and deliberately provide incomplete or incorrect information to obtain credit. If you request, you will be provided the name and address of any credit bureau from which we received a credit report.

As security for any loan advance to you or on your behalf, you grant the Credit Union a Security Interest in all individual and joint share or other accounts you have with the Credit Union now and in the future. When you are in default you authorize the Credit Union to take that money and apply it to what you owe. Shares and deposits that would have an adverse tax consequence if pledged as security are not subject to this Security Interest.

To help the government fight the funding of Terrorism and money laundering activities, Federal law requires all financial institutions to obtain, verify, and record information that identifies each person who opens an account. What this means for you: When you open an account, we will ask your name, address, date of birth, and other information that will allow us to identify you. We may also ask to see your driver's license and other identifying information.