Molex Employees Federal Credit Union - Secure Loan Application

Exit Secure Loan Application

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Please Enter your Email Address:

If you are applying for joint credit, secured credit or if you live in a community property state (AZ,CA,ID,LA,NM,NV,TX,WA,WI,Puerto Rico), please complete the following:
Married Separated Unmarried (Single, Divorced, Widowed)

Type of Loan Applied For:

NOTE: You must have a minimum of 6 mos. employment to be eligible to apply for a vehicle/secured loan, 2 yrs. for a signature loan, or 5 yrs. for a premium personal loan.
Please fax a copy of your most recent paycheck stub to our office @ (630) 416-4918.


Signature (up to $5000) Premium Personal (up to $10,000) New Car Used Car Boat Motorcycle
Share Secured  Stock Secured  Other:
*If you are applying for a vehicle loan you must fax a copy of your dealer's purchase agreement (630) 416-4918

Amount applied for: $
Purpose:
Desired Length of Repayment (mos):

Method of Payment:
Payroll Deduction (if current Molex employee) Payment Books (if employed elsewhere)

Are you a U.S. Citizen?
Yes No
Are you a permanent resident alien?
Yes  No

Have you ever had a judgment, bankruptcy, repossession, or lawsuit?
Yes  No


Applicant:

Name:
Account #:
Social Security #:
Birth date (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 Applicant:

Name:
Account #:
Social Security #:
Birth date (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: In order to expedite the processing of your loan application, please fax a copy of your most recent paycheck stub to (630) 416-4918. If you have a joint applicant (cosigner) their paycheck stub must be faxed as well. If you are self employed or retired, you may fax a financial statement or tax return for income verification.
Employer Name:

Employer Phone #:
Employer Address:

Position:
Date Hired (MM/DD/YY):
Monthly Gross Income: $
Other Income: $ per Month
Employer Name:

Employer Phone #:
Employer Address:

Position:
Date Hired (MM/DD/YY):
Monthly Gross Income: $
Other Income: $ per Month

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:

PERSONAL REFERENCE
In case we have difficulty reaching you, please list a relative who does not reside within your household:

Name:
Address:
City:
State:
Zip:
Phone:
Relationship:

 

CREDIT INFORMATION
Please list all open Accounts with a balance.
Applicant's
Creditors
Monthly
Payment
Housing
Rent Own None
Joint Applicant's
Creditors
Monthly
Payment
Housing
Rent Own None

Complete the following sections if you are applying for a vehicle loan:
Vehicle Make: Model:
Year: Engine Size: Mileage:
VIN or Serial#
Options or accessories to determine vehicle value:



Private Party Purchase
Name of Seller:
Phone# of Seller:
Address:

Dealer Purchase
Name of Dealer:
Phone# of Dealer:
Address:

If Private Party Purchase:
If private party still has a loan against the vehicle and the title is held by a leinholder:
Name of Finance Co. holding title:
Phone# of Finance Co.:
Account#:
Approximate payoff:
Address:


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.

By pressing the "Send Request" 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.

 

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  2003 Molex Employees Federal Credit Union