Unmarried (Single, Divorced, Widowed)
Loan Applied For:
Special Loan Other:
Desired Length of Repayment (mon):
Automatic Transfer from
Payment Protection Plan:
Would you like to purchase Credit Life Insurance:
Single Credit Life, (Only Available for Applicant)
Joint Credit Life,
Would you like to purchase Credit Disability
Single Credit Disability (Only Available for
Joint Credit Disability
you a U.S. Citizen?
you ever had a judgment, bankruptcy, repossesion, or lawsuit?
own your home or vehicle?
Home Value $
Vehicle(s) Value $
that everything stated in this application is correct to the
best of your knowledge. The Credit Union is authorized to
investigate your creditworthiness, employment history, and
to obtain a credit report and to answer questions about their
credit experience with you. You understand that any false
or misleading statement in your application may cause any
loan or extension of credit to be in default. You authorize
us to accept your facsimile signatures on this application
and agree that your facsimile signature will have the same
legal force and effect as your original signature. You assume
any risk that may be associated with permitting us to accept
your facsimile signature.
By pressing the
"Send Application" button below, you agree to the above statement.
You understand that we may require your signature on additional
documents prior to disbursing any credit proceeds.