Secure Loan Application

Loan Information

Loan Type

Loan Purpose

Requested Amount ($)

I have read and agree with the Credit Card Terms and Conditions

Applicant Information

First Name

Last Name

Non-Member

Member #

Social Security #

Date of Birth

Marital Status

Email Address

Phone Number

Driver's License

Applicant's Present Address

Street Address

City

State

Zip Code

Years at this address

Housing Status

Monthly Housing Expense

Applicant's Previous Address

Street Address

City

State

Zip Code

From

To

Applicant's Employment Information

Applicant's Present Employer

Present Employer

Occupation

Street Address

City

State

Zip Code

Employer Phone #

Employment Start Date

Hourly Rate Income for the Employer Above

Whole Dollars. If you would like us to include other sources of income, please discuss this with our Loan Officers. Alimony, child support, or separate maintenance income need not be revealed if you do not choose to have it considered as a basis for repaying this obligation.

Applicant's Previous Employer

Previous Employer

Occupation

Street Address

City

State

Zip Code

Employer Phone #

Employment Start Date

Employment End Date

Applicant's Other Income

Part-Time Income / 2nd Income per Month

Applicant Personal References

Please provide references.

First and Last Name

Relationship To You

Phone Number

First and Last Name

Relationship To You

Phone Number

First and Last Name

Relationship To You

Phone Number

Is there a joint applicant?

No Yes

Joint Applicant Information

First Name

Last Name

Non-Member

Member #

Social Security #

Date of Birth

Marital Status

Email Address

Phone Number

Driver's License

Joint Applicant's Present Address

Street Address

City

State

Zip Code

Years at this address

Housing Status

Monthly Housing Expense

Joint Applicant's Previous Address

Street Address

City

State

Zip Code

From

To

Joint Applicant's Employment Information

Joint Applicant's Present Employer

Present Employer

Occupation

Street Address

City

State

Zip Code

Employer Phone #

Employment Start Date

Hourly Rate Income for the Employer Above

Whole Dollars. If you would like us to include other sources of income, please discuss this with our Loan Officers. Alimony, child support, or separate maintenance income need not be revealed if you do not choose to have it considered as a basis for repaying this obligation.

Joint Applicant's Previous Employer

Previous Employer

Occupation

Street Address

City

State

Zip Code

Employer Phone #

Employment Start Date

Employment End Date

Joint Applicant's Other Income

Part-Time Income / 2nd Income per Month

Joint Applicant Personal References

Please provide two references.

First and Last Name

Relationship To You

Phone Number

First and Last Name

Relationship To You

Phone Number

Comments

Enter Comments Here

READ CAREFULLY BEFORE SIGNING/SUBMITTING. PER YOUR MEMBERSHIP AGREEMENT AND /OR LOAN AGREEMENTS WITH THE GREATER PITTSBURGH FCU (gpfcu) YOU GIVE US A SECURITY INTEREST IN YOUR ACCOUNT(S) AND CERTAIN OTHER PROPERTY PLEDGED AS DESCRIBED IN SAID AGREEMENTS.

By submitting this application by facsimile or electronically, you agree to the same terms that apply to a signed application. If there is a co-applicant on this loan, the co-applicant has authorized the submission of this application. This facsimile or electronic submission qualifies as your signature. It is understood that you will have to sign loan documents before funds can be disbursed.

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

I have read this section and agree to the terms.