Name: First, Middle, Last
Are you interested in having your loan protected?
If you answer "yes", the credit union will disclose the cost to protect your loan. The
Credit Insurance is voluntary and does not affect your loan approval. In order for your
loan to be covered, you will need to sign a separate application that explains the terms
Would you like
to purchase Credit Life Insurance?
Single Credit Life
Joint Credit Life
Would you like to purchase Credit Disability
Would you like to purchase GAP Insurance? (Cost
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 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 forceand 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 additional information to finalize our credit decision and your
signature on additional documents prior to disbursing any credit proceeds.