8700 Beverly Boulevard. South Tower Street Level. Los Angeles, CA 90048
Phone: (310) 423-5549 | Fax: (310) 423-0276



WE R HERE 4 U LOAN APPLICATION

The “We R Here 4 U Loan” is set up for credit union members to have a place to go to for emergency money without paying the high interest charges of outside companies or individuals. Loan amounts range from $200-$1,000 depending on your annual salary.
There is a $20.00 application fee.

Type Of Loan Applying For

Loan Special

Purpose of loan : Requested Amount : $ .00

Payment Protection Coverage
Check coverage(s) desired. The Credit Union will disclose the cost of this voluntary insurance to you. A separate enrollment form which discloses the terms and conditions must be signed for coverage to become effective.
Single Credit Life Disability                                       None
Single Credit Life Insurance                                      Joint Credit Life Insurance                                      None

Applicant Information
Applicant's Name:
Account #:
Driver License #:
Social Security #:
US Citizen: Yes No
Birthdate:
Please indicate your marital status if you are applying for joint credit, secured credit or if you live in a community property state:
Marital Status:
Home Phone #:
Mobile Phone #:
Street Address #:
City: State:
Zip #:
Current Address since: (MM/YY)
If less than 3 yrs enter previous address:
Applicant Employer's Name:
Employer Phone #:
Employer Address :
Department:
Supervisor:
Position:
Date Hired (MM/DD/YY):
Monthly Gross Income ($):
Other Income ($): per Month
Complete if current employment is less than 2 years
Previous Employers Name:
Yrs Employed:

Debts & Assets
Debts
Type
Amount
Min. Pmt.
Enter Mortgage/Rent:
$ .00
$ .00
Are you at least 18 years of age? Have you ever filed for bankruptcy or had debt adjustment under Chapter 13?

References (Nearest relative not living with you)
First Name: Middle Name: Last Name: Suffix:
   Home Phone Number:
   555-555-5555
   What is their home address?
Street: City: State: Zip:
   What is the relationship?

Submit Application
You agree 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 "Submit 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.