Secure Loan Application
3856 Southwest Boulevard, Tulsa, OK   74107
Phone: (918) 445-1968   •  Toll Free: 1-888-445-2783   •    Fax: (918) 445-5126
Account Number - If You Are A Member Amount Requested Type Of Loan Applying For Term
$ Months
PRIMARY APPLICANT
  
JOINT APPLICANT

Name: First, Middle, Last

 Name: First, Middle, Last
Social Security Number:
 Date of Birth:
 
Social Security Number:
 Date of Birth:
What Is Your Email Address?
   What Is Your Email Address?
Home Phone Number:
 Cell Phone Number:
I Can Be Best Reached Via:
 
Home Phone Number:
 Cell Phone Number:
I Can Be Best Reached Via:
What Is Your Home Address?
Street: City:
  What Is Your Home Address?
Street: City:
State: Zip:
 
State: Zip:
Monthly Housing Payment/Rent: $   Monthly Housing Payment/Rent:  $
     
PRIMARY APPLICANT EMPLOYMENT
  
JOINT APPLICANT EMPLOYMENT
Current Employer:
 Work Phone:
 
Current Employer:
 Work Phone:
Gross Salary: $       Gross Salary: $    
Frequency:   Frequency:
Other Income: $   Other Income: $
Frequency:   Frequency:
Source Of Income:   Source Of Income:
 
OTHER INFORMATION
(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.)
 
Have You Filed For Bankruptcy? Are You A U.S. Citizen Or Permanent Resident Alien?
Is your income likely to reduce in the next two years?
Are You  A Co-Maker/Endorser On Any Loan?
If Yes, Then For Whom? Balance:
Do You Currently Have Any Outstanding Judgements Or Have You Had A Debt Adjustment, Repossession, Or Property Foreclosed In The Last 7 Years Or Are A Party To A Lawsuit?

You promise that everything you have stated in this application is correct to the best of your knowledge. You authorize the credit union to obtain credit reports in connection with this application for credit and for any update, renewal or extension of the credit received. You understand that the credit union will rely on the information in this application and your credit report to make its decision. You authorize us to accept your facsimile signatures on this application and agree that your facsimile will have the same legal force and effect as your original signature. Security on one loan is security for any monies owed to the credit union.

Please mail, fax, or bring into our office your most recent pay check stub.

By pressing the “Submit 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 proceeds.