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Secure Loan Application


1 South Family Drive Albany, NY 12205
Phone: (800) 593-5920  •  Fax: (518) 452-9065

   
Type Of Loan Applying For

New/Used Vehicle Loan
New/Used Boat Loan
Recreational Vehicle (Camper, ATV, Motorcyle, etc.)


Amount Requested: $ .00

Purpose / Collateral:



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 Insurance                              Joint Credit Life Insurance                              None
Single Credit Disability                                     Joint Credit Disability                                    None


Applicant Information
Applicant's Or Business Name:
Account #:
Social Security #:
Email:
US Citizen: Yes No
Birthdate: (MM/DD/YY)
Home Phone #:
Cell Phone #:
Street Address:
City: State:
Zip #:
Current Address since: (MM/YY)
Rent     Own     Payment:
Joint / co-applicant / Guarantor Name:
Is Joint Applicant your spouse? Yes No
Account #:
Social Security #:
Email:
US Citizen: Yes No
Birthdate: (MM/DD/YY)
Home Phone #:
Cell Phone #:
Street Address:
City: State:
Zip #:
Current Address since: (MM/YY)
Rent     Own     Payment:


Employment Information
Applicant Employer's Name:
Employer Phone #:
Employer Address:
Position:
Status: Full Time Part Time
Years at Current Job:
Monthly Gross Income ($):
Other Income ($): per Month
Complete if current employment is less than 2 years:
Previous Employers Name:
Yrs Employed:
Joint App. Employer's Name:
Employer Phone #:
Employer Address:
Position:
Status: Full Time Part Time
Years at Current Job:
Monthly Gross Income ($):
Other Income ($): per Month
Complete if current employment is less than 2 years:
Previous Employers Name:
Yrs Employed:

NOTE: Alimony, child support, or separate maintenance income need not be revealed if You do not choose to have it considered as a basis for this credit request.


Debts & Assets
Child Support Payments / Alimony $
Assets:
Description: Value:
    
Description: Value:
    
Have you ever filed for bankruptcy or had debt adjustment under Chapter 13?
   Are you a party in a lawsuit?
   Have you ever had property foreclosed or repossesion in the last 7 years?
   Is your income likely to decline in the next two years?
Are you co-maker/endorser on any loan not listed above?
   If yes then for whom?
   If yes then to whom?


Contact Method

To avoid delays in processing your request please provide us with the best method and time to contact. Best method of contact:
Home Phone      Mobile Phone      Work Phone      What time of day is best to call:

OR:

Email:

  Additional Comments:



Submit Application

I/We understand that credit union membership is required to fully process this loan application and further documentation / signatures may be required. By submitting this form with your electronic signature(s), you agree that everything stated in this application is correct to the best of your knowledge and grant permission to Directors Choice Credit Union to perform the following. Directors Choice CU is authorized to validate your information, investigate your creditworthiness, employment history, and obtain a credit report. 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. Directors Choice CU may keep this application whether or not it is approved.

By pressing the "Submit Application" button below, you agree to the above statement.  

Date:
Authorized Signature:
Secondary Signature: