5702 W. US HWY 2, Hurley, WI 54534
Phone: (715) 561-2842  •  Fax: (715) 561-3364
Secure Loan Application

NOTICE: We can only accept applications and offer services to current credit union members or those eligible for membership. Other applications will not be processed. Thank you.

You may apply for individual or joint credit, but choose only one of the following. If this is a joint application, please fill out the joint applicant information. If the information is the same for the joint applicant as the primary (example: address, phone etc.) simply type "Same" in the blank. Thank you.

Notice to married applicant: No provision of a marital property agreement, a unilateral statement under Wis. Stat. sec 766.59 or a court decree under Wis Stat. sec 766.70 adversely affects the interests of the credit union unless prior to the time the credit is extended, the credit union is furnished with a copy of the agreement statement or decree, or has actual knowledge of the adverse provision when the obligation to the credit union is incurred.

Please Enter your Email Address:

You may apply for individual or joint credit, but check only one of the following options.
Individual Credit - unmarried applicant. Complete only the left hand column and other sections as they apply.
Individual Credit - married applicant. If both you and your spouse are residents of Wisconsin, complete both the left and right hand columns. If either you or your spouse are not Wisconsin residents, complete only the left hand column.
Joint Credit - with your spouse. Complete both the left and right hand columns and other sections as they apply, and sign the following:
We intend to apply for joint credit: X____________________________ X____________________________
Joint Credit - with another applicant or cosigner who is not your spouse. Each of you must complete a separate application. If both you and your spouse are Wisconsin residents incude information about your spouse in the right hand column, and sign the following:
I intend to apply for joint credit with: X____________________________ X____________________________

Purpose of Loan Applied For:
Personal (Signature) Savings New Car Used Car
Home Equity  ATV/Boat/Motorcycle Other:

Purchasing Vehicle from Dealer Purchasing from Individual Currently Own Vehicle Collateral

Collateral (year, make, model, cyl.):
ID Number:

Amount applied for: $
Desired Length of Repayment (months):

Would you like to purchase Credit Life & Disability Insurance?
Applicant
Joint
None

Applicant:
Name:
Account #:
Social Security #:
Birthdate (MM/DD/YY):
Home Phone #:
Present Address:
Street:
City:
State & Zip:
Current Address since: (MM/YY)
If less than 3 yrs enter previous address:

 Joint / Spouse Information:
Name:
Account #:
Social Security #:
Birthdate (MM/DD/YY):
Home Phone #:
Present Address:
Street:
City:
State & Zip:
Current Address since: (MM/YY)
If less than 3 yrs enter previous address:
Employment and Income:
Employer Name:

Employer Phone #:
Employer Address:

Position:
Length of Employment:
Monthly Net Income: $
Other Income: $ per Month
Source of Other Income/ Employer Name:

Length of Employment:
Employer Name:

Employer Phone #:
Employer Address:

Position:
Length of Employment:
Monthly Net Income: $
Other Income: $ per Month
Source of Other Income/ Employer Name:

Length of Employment:

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.
Complete if current is less than 2 years:
Previous Employers Name:

Years Employed:

Complete if current is less than 2 years:
Previous Employers Name:

Years Employed:

Please tell us about your assets:
  a - Cash or equivalent: $ .00
  b - Market Value of Home you Own: $ .00
  c - Other assets (excluding real-estate): $ .00
   
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
Have you filed for bankruptcy?
  a - Has this bankruptcy been discharged over four years ago?
  b - (If less than four years) What year was the bankruptcy discharged?
Are you co-maker/endorser on any loan not listed above?
  a - If yes then for whom?
  b - If yes then to whom?
Are you a U.S. citizen or permanent resident alien?
 
References:
Nearest Relative NOT Living with you:
  a - Name:
First: Middle: Last: Suffix:
  b - Home Phone Number:
555-555-5555
  c - What is their home address?
Street: City: State: Zip:
  d - What is the relationship?

Applicant's
Signature: _______________________________________________
(to be signed at closing)

Other
Signature: _______________________________________________
(to be signed at closing)

This section required by Wisconsin Law

I certify that the credit being applied for,if granted, will be incurred or obtained during marriage and will be in the interest of the marriage or family.
I Agree Not Applicable

This statement is made in accordance with Wis. Stat. Sec. 766.55(1).
If this section applies, we are required by Wisconsin law to notify your spouse by mail if your loan is granted.

I/We 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.

By pressing the "Send 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.