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Secure Loan Application Form

250 Chester St. #1-E, Painesville, OH 44077
Phone: (440) 358-2100 | Fax: (440) 358-2100
   
Type Of Loan Applying For

Type: New Auto Loan       Used Auto Loan       Recreational Vehicle (Boat, Camper, ATV, Motorcyle)

        Personal Loan (Signature)       Share Secured Loan

Amount Requested: $ .00      
Purpose of Loan:
Please specify "pre-approval" OR year, make, model and mileage for any type of vehicles. For personal or share secured loans, please state purpose.
Desired Term (months):


Payment Protection Coverage
Check coverage(s) desired. The Credit Union will disclose the cost of this voluntary insurance to you and finance the premium as part of the loan
Single Credit Disability       None
Single Credit Life Insurance       Joint Credit Life Insurance       None


Applicant Information
Applicant's Name:
Account #:
Email:
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 #:
Cell Phone #:
Street Address:
City: State:
Zip #:
  Own     Rent    Other
Current Address since: (MM/YY)
If less than 3 yrs enter previous address:
Joint Applicant's Name:
Account #:
Relationship:
Driver License #:
Social Security #:
US Citizen: Yes No
Email:
Birthdate:
Home Phone #:
Cell Phone #:
Street Address:
City: State:
Zip #:
Current Address since: (MM/YY)
If less than 3 yrs enter previous address:


Employment Information
Avery Dennison Division :
Avery Dennison Mail #:
Employer Name if no longer with Avery Dennison:
Employer Address :
Date Hired (MM/DD/YY):
Gross Annual Income ($):
Hourly Rate of Income ($):
Other Income ($): per Month
Source:
Joint App. Employer's Name:
Employer Phone #:
Employer Address:
Department:
Supervisor:
Position:
Date Hired (MM/DD/YY):
Gross Annual Income ($):
Hourly Rate of 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
Type
Lender
Balance
Min. Pmt.
$ .00
$ .00
$ .00
$ .00
$ .00
$ .00
$ .00
$ .00
$ .00
$ .00
$ .00
$ .00
$ .00
$ .00
$ .00
$ .00
$ .00
$ .00
Child Support Payments / Alimony $
Have you ever filed for bankruptcy?     What Year?
Do you have any judgements, garnishments, foreclosures, reposessions, or legal proceedings against you?     What Year?
Are you co-maker/endorser on any loan not listed above?
   If yes then for whom?
   If yes then to whom?
Are you a member of the military?


Reference (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?


Reference (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?


Contact Method
  Best contact Method? Home Phone Cell Phone Email
 
  Additional Comments:


Final Loan Application Requirements
  • Copy of recent paystub (For Applicant and Co-applicant). And/Or proof of income from other sources.
  • Signature on loan documents.
    		•


    Submit Application

    By Submitting this you agree to the following:

    You promise that everything you have stated in this application is correct to the best of your knowledge and that the above information is a complete listing of what you owe. 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, renewal or extension 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.