Master Loan Application  (Please print document, complete, and mail to the credit union.)
NOTICE TO MARRIED APPLICANTS: You have the right to apply for a separate account in your name.

CHECK TYPE OF CREDIT REQUESTED
 Individual Credit

 Joint Credit

 
I/WE WOULD LIKE A LOAN OF: $ __________________________
FOR THE FOLLOWING PURPOSE: _________________________
SECURITY OFFERED: ____________________________________
ACCOUNT NUMBER: _____________________________________

A. INFORMATION REGARDING APPLICANT

 MARRIED    UNMARRIED    SEPARATED

 
NAME_________________________________________ DATE OF BIRTH__________________________________
SOC. SEC. NO._________________________________ DRIVER'S LIC. # & STATE__________________________
PRESENT ADDRESS____________________________ HOW LONG? _______________YRS. _____________MOS.
PREVIOUS ADDRESS___________________________ HOW LONG? _______________YRS. _____________MOS.
HOME PHONE_________________________________ AGES OF DEPENDENTS____________________________
PRESENT EMPLOYER'S NAME
___________________________________________________________________DATE EMPLOYED______________
OCCUPATION__________________________________ MONTHLY GROSS PAY____________________________
SUPERVISOR'S NAME__________________________ WORK PHONE_____________________________________
PREVIOUS EMPLOYER'S NAME & ADDRESS
_______________________________________________________________________________________________
OCCUPATION________________________________ HOW LONG? ______________YRS. _______________MOS.
SOURCE OF OTHER INCOME____________________ AMOUNT OF OTHER INCOME___________________/month
OTHER INCOME NOTICE: Do not list alimony, child or spousal support or separate maintenance payments unless you wish them considered as a basis for repayment of the credit requested. If listed, verification may be requested.
ESTIMATED VALUE OF HOME ____________________________________________________________________

B. INFORMATION REGARDING  CO-APPLICANT    GUARANTOR  
NAME________________________________________ DATE OF BIRTH____________________________________
SOC. SEC. NO.________________________________ DRIVER'S LIC. # & STATE___________________________
PRESENT ADDRESS_______________________________________________________________________________
HOME PHONE_________________________________ HOW LONG? YRS._______________ MOS.______________
PRESENT EMPLOYER'S NAME & ADDRESS
___________________________________________________________________DATE EMPLOYED______________
OCCUPATION_________________________________ MONTHLY TAKE HOME PAY_________________________
WORK PHONE_________________________________ AMOUNT OF OTHER INCOME________________________
SOURCE OF OTHER INCOME___________________ TOTAL MONTHLY INCOME (B) $______________________
OTHER INCOME NOTICE: Do not list alimony, child or spousal support or separate maintenance payments unless you wish them considered as a basis for repayment of the credit requested. If listed, verification may be requested.
C. FINANCIAL INFORMATION & REFERENCES

 
NAME AND ADDRESS OF RELATIVE NOT LIVING WITH YOU
________________________________________________________________________________________________
PHONE NUMBER:__________________________________ RELATIONSHIP:______________________________

NAME AND ADDRESS OF PERSONAL REFERENCE NOT RELATED TO YOU
________________________________________________________________________________________________
PHONE NUMBER:__________________________________

NAME AND ADDRESS OF BANK OR OTHER FINANCIAL INSTITUTION
________________________________________________________________________________________________
TYPE OF ACCOUNTS:______________________________


If you answer "yes" to any of these questions, please attach details.
ARE ANY OF YOUR DEBTS PAST DUE?    YES    NO
HAVE YOU EVER HAD YOUR AUTO, FURNITURE OR PROPERTY REPOSSESSED?    YES    NO
HAVE YOU OR YOUR CO-APPLICANT EVER DECLARED BANKRUPTCY?    YES    NO
ARE YOU CURRENTLY A CO-MAKER ON A LOAN?    YES    NO

D. LIST ALL EXISTING DEBTS OF APPLICANT (and Co-Applicant or Spouse if any part of section C is applicable)

 
App Co-App Name & Addresses of Creditor Account # Original Amt Present Bal Monthly Payment
    Home Mortgage or Landlord

 

  $ $ $
    Credit Card/Other

 

 

 

 

 

  $ $ $
    Automobile Loan/creditor

 

 

Auto Make Model & Year $ $
    List alimony, child support
or child care paid monthly:
      $
Do not omit any debts! If more space is needed, use separate sheet. Incomplete applications cannot be processed.
Total Monthly Obligations $__________________________

F. INSURANCE INFORMATION

 I would like information on the insurance coverage(s) checked below.

 Single Credit Life    Joint Credit Life    Credit Disability

MASTER APPLICATION SIGNATURES

APPLICANT'S
SIGNATURE_______________________________________________________DATE___________

OTHER SIGNATURE
(Where Applicable)___________________________________________________DATE___________


HAVE YOU OMITTED ANYTHING? REMEMBER: INCOMPLETE APPLICATIONS CANNOT BE PROCESSED.

 

ADDITIONAL COMMENTS:

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