| * Required Field |
| * Name | |
| Best Phone # To Reach You | () - |
| Best Time to Call You | |
| * Purpose of Loan | |
| * Amount Requested | |
| Down Payment | |
| * Term (Months) | |
| Application Type |
|
Please Tell Us About Yourself (Primary Borrower) |
| * CFCU Account Number | |
| * Full Name | |
| * Birth Date | / / (mm/dd/yyyy) |
| * Social Security Number | - - |
| Marital Status |
|
| * Number of Dependents | |
Address (Primary Borrower) |
| * Street Address | |
| * City | |
| * State | |
| * Zip Code | |
| * Years There | |
| Do you... |
|
| Home Value (if owned) | |
If you have been at your current address for less than 2 years, please provide information about your previous residence. |
| Previous Address | |
| City | |
| State | |
| Zip Code | |
| Years there | |
| Did you... |
|
Contact Information (Primary Borrower) |
| * Home Phone | () - |
| Work Phone | () - ext |
| Cell Phone | () - |
| Fax | () - |
| Email | |
Assets (Primary Borrower) |
Your Vehicles
|
| Other Properties Owned | |
| Other Checking Acct - Bank Name | |
| Other Savings Acct - Bank Name | |
Employment Information (Primary Borrower) |
| * Current Employer's Name | |
| * Address | |
| * City | |
| * State | |
| * Zip Code | |
| * Phone | () - |
| * Position | |
| * Supervisor | |
| * Years there | |
| * Income | |
If you have been with your current employer less than two years, please provide information on your previous employer. |
| Previous Employer's Name | |
| Address | |
| City | |
| State | |
| Zip Code | |
| Phone | () - |
| Position | |
| Supervisor | |
| Years there | |
| Income | |
Other Income: Monthly dollar amount that you recieve in alimony, child support, or separate maintenance - this income need not be revealed if you do not wish to have it considered as a basis for repaying this obligation. |
| Other Income | |
| Source | |
Relatives (Primary Borrower) |
Please list two of your nearest relatives who are not living with you. |
| * Full Name - Relative 1 | |
| * Home Address | |
| * City, State & Zip Code | |
| * Primary Phone | () - ext |
| * Relationship | |
| * Full Name - Relative 2 | |
| * Home Address | |
| * City, State & Zip | |
| * Primary Phone | () - ext |
| * Relationship | |
Statement of Total Indebtedness and Liabilities
(Primary Borrower)
|
|
Please tell us about yourself (Secondary Borrower) |
| CFCU Account Number | |
| Full Name | |
| Birth Date | / / (mm/dd/yyyy) |
| Social Security Number | - - |
| Marital Status |
|
| Number of Dependents | |
Address (Secondary Borrower) |
| Same as Primary Borrower |
|
If the Secondary Borrower's address is not the same as the Primary Borrower's, please fill in the address information below. |
| Street Address | |
| City | |
| State | |
| Zip Code | |
| Years there | |
| Do you... |
|
| Home Value (if owned) | |
If the Secondary Borrower has been at the current address for less than 2 years, and if the Secondary Borrower's previous address is different from the Primary Borrower's please provide information about the Secondary Borrower's previous residence. |
| Previous Address | |
| City | |
| State | |
| Zip Code | |
| Years there | |
| Did you... |
|
Contact Information (Secondary Borrower) |
| Home Phone | () - |
| Work Phone | () - ext |
| Cell Phone | () - |
| Fax | () - |
| Email | |
Assets (Secondary Borrower) |
Vehicles
|
| Other Properties Owned | |
| Other Checking Acct - Bank Name | |
| Other Savings Acct - Bank Name | |
Employment Information (Secondary Borrower) |
| Current Employer | |
| Address | |
| City | |
| State | |
| Zip Code | |
| Phone | () - |
| Position | |
| Supervisor | |
| Years there | |
| Income | |
If the Secondary borrower has been with the current employer for less than 2 years please provide information on the Secondary Borrower's previous employer. |
| Previous Employer | |
| Address | |
| City | |
| State | |
| Zip Code | |
| Phone | () - |
| Position | |
| Supervisor | |
| Years there | |
| Income | |
Other Income: Monthly dollar amount that the Secondary Borrower recieves in alimony, child support, or separate maintenance - this income need not be revealed if you do not wish to have it considered as a basis for repaying this obligation. |
| Other Income | |
| Source | |
Relatives (Secondary Borrower) |
Please list two of your nearest relatives who are not living with you. |
| Full Name - Relative 1 | |
| Home Address | |
| City, State & Zip Code | |
| Primary Phone | () - ext |
| Relationship | |
| Full Name - Relative 2 | |
| Home Address | |
| City, State & Zip Code | |
| Primary Phone | () - ext |
| Relationship | |
Statement of Total Indebtedness
(Secondary Borrower)
|
Click the "I accept the terms of the disclaimer above and submit my application" button to send the application to us via the Internet after reading the disclaimer below. By clicking "I accept the terms of the disclaimer above and submit my application", you accept the terms of the disclaimer below. DISCLAIMER: I/WE HEREBY CERTIFY THAT ALL STATEMENTS MADE ARE TRUE AND COMPLETE, ARE SUBMITTED FOR THE PURPOSE OF OBTAINING CREDIT, AND THAT THE CREDIT UNION MAY RELY ON THEM FOR SUCH DETERMINATION. I/WE AUTHORIZE YOU TO OBTAIN SUCH INFORMATION AS YOU MAY REQUIRE CONCERNING THE STATEMENTS MADE IN THIS APPLICATION, AND AGREE THAT THE APPLICATION SHALL REMAIN YOUR PROPERTY, AND YOU ARE AUTHORIZED TO ANSWER QUESTIONS ABOUT YOUR CREDIT EXPERIENCE WITH ME/US. Applicant Signature: ______________________________________________________
Date: ____________________ Co-applicant Signature: ______________________________________________________
Date: ____________________
|
| Security Code What's this? | |
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