S&J School Employees Home Page

Secure Loan Application Form

PO Box 2161, Wintersville OH 43953
Phone: (740) 266-6354

   
Type Of Loan Applying For
* Must be a member to apply

Type:

Amount Requested: $ .00      

Term: Months      



Payment Protection Coverage
Would you like to purchase:
Credit Life Insurance?
Single Credit Life (Only Available for Applicant) 
Joint Credit Life
None
Single Credit Disability Insurance?
Yes
None
GAP Insurance?
Yes
None


Applicant Information
Applicant's Name:
Account #:
Social Security #:
Email:
US Citizen: Yes No
Birthdate:
Home Phone #:
Cell Phone #:
Street Address:
City: State:
Zip #:
Monthly House Payment: $ .00
Joint Applicant's Name:
Account #:
Social Security #:
Email:
US Citizen: Yes No
Birthdate:
Home Phone #:
Cell Phone #:
Street Address:
City: State:
Zip #:
Monthly House Payment: $ .00


Employment Information
Applicant Employer's Name:
Employer Phone #:
Monthly Gross Income ($):
Other Income ($): per Month
Other Income Source:
Joint App. Employer's Name:
Employer Phone #:
Monthly Gross Income ($):
Other Income ($): per Month
Other Income Source:

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.


Debts & Assets
Have you ever filed for bankruptcy or had debt adjustment under Chapter 13?
   Are you a party in a lawsuit?
   Have you ever had property foreclosed or repossesion in the last 7 years?
Are you co-maker/endorser on any loan not listed above?
   If yes then for whom?
   Balance:


Submit Application

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 force and effect as your original signature. You assume any risk that may be associated with permitting us to accept your facsimile signature. Security on one loan is security on any monies owed to the Credit Union.

PLEASE MAIL, FAX, OR BRING INTO TO OUR OFFICE YOUR MOST RECENT PAY CHECK STUB.

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.