Loan Application

Loan Information
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General Information
Will there be a co-applicant on this application
Marital Status: Complete marital status if this loan is for:
  a. Joint or secured credit, or
  b. You reside in or rely on property located in a Community Property State. (AZ, CA, ID, LA, NM, NV, TX, WA, WI)



Primary Applicant Personal Information
   
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(-
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Type of Residence    
 
Time at Current Residence


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Alimony, child support, or separate maintenance income need not be revealed if you do not wish to have it considered as a basis for repaying this obligation.
Primary Applicant Employment/Income
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$
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Co-Applicant Personal Information
   
(-
(-
(-
 
 
Type of Residence  
 
Time at Current Residence


$
   
$
   
Alimony, child support, or separate maintenance income need not be revealed if you do not wish to have it considered as a basis for repaying this obligation.
Co-Applicant Employment/Income
(-
$
$
Please list other liabilities
For example: home association dues, alimony, child support, child care, auto insurance, tax liabilities, etc. If you need additional room, please use the "Special Instructions/Comments" section.
Obligation Monthly Payments
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$
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Additional Information
How would you prefer to be contacted?
 

Income verification and other information may be required

State Law Notices

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.

Signatures

  1. You promise that everything you have stated in this application is correct to the best of your knowledge.  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 federal crime to willfully and deliberately provide incomplete or incorrect information on loan applications made to federal credit unions or state chartered credit unions insured by NCUA
  2. You have received and read the LOANLINER Credit and Security Agreement, including the Addendum (“Agreement”) and a Credit Insurance Certificate.  By signing below you agree to be bound by the terms of the Agreement.
  3. If you are applying for a credit card you understand that use of your credit card will constitute acknowledgment of receipt and agreement to the terms of the credit card agreement and disclosures.
  4. You grant us a security interest in all-individual and joint share and/or deposit accounts you have with us now and in the future to secure what you owe under the Agreement and if you have applied for a credit card, under the credit card agreement.  When you are in default, you authorize us to apply the balance in these accounts to any amounts due.  Shares and deposits in an Individual Retirement Account and any other account that would lose special tax treatment under state or federal law if given as security are not subject to the security interest you have given in your shares and deposits.
Primary Applicant Signature
Co-Applicant Signature

You may be required to sign a form in person at a future date.

Security Code