FIRST RELIANCE FEDERAL CREDIT UNION
205 Collins Industrial Blvd., Athens, GA 30601
Phone:
(706) 613-1644  •  Fax: (706) 613-1950
Secure Loan Application
1. Member Number

You must be a First Reliance Federal Credit Union member to apply for a loan.
 
2 .Type Of Loan Applying For

New Auto Loan
Used Auto Loan
Refinance Outside Auto Loan

Savings Secured
Other
        Description:
 
3. Loan Terms
3.1 - Are you submitting individually or jointly?
3.2 - Desired loan amount: $
3.3 - Repayment term:
3.4- What collateral will you provide?
   3.4a - Description of collateral:
(ie., yr, make, model)
   3.5b - What is the value of the collateral? $ .00
3.6 - Method of Payment:
 
4. PRIMARY APPLICANT
4.1 - Name:
First: Middle: Last: Suffix:
4.2 - What is your home address?
Street: City: State: Zip:
4.3 - Rent/Own/Buying:
   4.3a - Payment Amount:
4.4 - Time at residence:
4.5 - Previous address (if less than 2 years at current residence):
Street: City: State: Zip:
4.6 - Home Phone Number:
555-555-5555
4.7 - What is your e-mail address?
(Re-enter your e-mail address)
4.8 - Date of birth:
mm/dd/yy
4.9 - Social Security Number:
555-55-5555
4.10 - Drivers License
4.11 - Mother's Maiden Name:
4.12 - Current employer:
4.13 - Title or position:
4.14 - Are you self employed?
  4.14a - Type of Business
4.15 - Business phone number:
ext.
555-555-5555
4.16 - Date Started Position:
mm/dd/yy
(You do not need to provide information about alimony, child support, separate maintenance or other sources of income if you do not wish to have them considered as income.)
4.17 - Salary: $ .00
4.18 - Other income: $ .00
  4.18a - Source of income:
If Applying For An Individual Loan Click Here

5. JOINT APPLICANT
5.1 - Joint Applicant Type:   
5.2 - Name:
First: Middle: Last: Suffix:
5.3 - What is your home address?
Street: City: State: Zip:
5.4 - Rent/Own/Buying:
   5.4a - Payment Amount:
5.5 - Time at residence:
5.6 - Previous address (if less than 2 years at current residence):
Street: City: State: Zip:
5.7 - Home Phone Number:
555-555-5555
5.8 - What is your e-mail address?
(Re-enter your e-mail address)
5.9 - Date of birth:

mm/dd/yy
5.10 - Social Security Number:

555-55-5555
5.11 - Drivers License:
5.12 - Mother's Maiden Name:
5.13 - Current employer:
5.14 - Title or position:
5.15 - Are you self employed?
  5.15a - Type of Business:
5.16 - Business phone number:
ext.
555-555-5555
5.17 - Date Started Position:
mm/dd/yy
(You do not need to provide information about alimony, child support, separate maintenance or other sources of income if you do not wish to have them considered as income.)
5.18 - Salary: $ .00
5.19 - Other income: $ .00
  5.19a - Source of income:
 
6. Debts & Assets
6.1 - Please tell us about your assets:
  6.1a - Cash or equivalent: $ .00
  6.1b - Market Value of Home you Own: $ .00
  6.1c - Other assets (excluding real-estate): $ .00
6.2 Please tell us about your debts:
Lender
Type
Balance
Min. Pmt.
$ .00
$ .00
$ .00
$ .00
$ .00
$ .00
$ .00
$ .00
$ .00
$ .00
$ .00
$ .00
$ .00
$ .00
$ .00
$ .00
$ .00
$ .00
6.3 - Have you ever filed for bankruptcy or had debt adjustment under Chapter 13?
  6.3a - Are you a party in a lawsuit?
  6.3b - Have you ever had property foreclosed or repossesion in the last 7 years?
  6.3c - Is your income likely to decline in the next two years?
6.4 - Are you co-maker/endorser on any loan not listed above?
  6.4a - If yes then for whom?
  6.4b - If yes then to whom?
6.5 - Are you a U.S. citizen or permanent resident alien?
   
7. References
7.1 - Nearest Relative NOT Living with you:
  7.1a - Name:
First: Middle: Last: Suffix:
  7.1b - Home Phone Number:
555-555-5555
  7.1c - What is their home address?
Street: City: State: Zip:
  7.1d - What is the relationship?

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.

Effective August 1, 2011, there will be a $10.00 Loan Application fee for all Closed-End Consumer Loans.  This fee is implemented in order to cover the increased cost of pulling credit reports.  The fee will be reimbursed if the loan application is approved and once the member receives the loan proceeds.

Management & Board of Directors
June 15, 2011

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.
   

Submit Application