Please Note: UECU's On-Line Loan Applications can only be used for conventional consumer loans or VISA® Credit Card loans. If you wish to apply for a Home Equity Loan, a Home Equity Line of Credit Loan, you must Contact The United Equity Credit Union office in Decatur or Galesburg, Illinois to have the appropriate application and disclosure mailed to you. Click Here for phone numbers and addresses.


APPLICANT MUST COMPLETE:
Equal Credit Opportunity Act Information - Indicate the type of account that you are applying for by checking the appropriate box.
Individual Loan - Complete "Applicant's Information"
Joint Loan - Complete "Applicant's Information" and "Other Applicant's Information"
Individual Loan with Guarantor - Complete "Applicant's Information" and "Other Applicant's Information"
Applicant
Full Name:
Account Number:
Email Address:
Contact Phone #:

CO-APPLICANT MUST COMPLETE:
Equal Credit Opportunity Act Information - Indicate the type of account that you are applying for by checking the appropriate box.

Joint Loan
Individual Loan with Guarantor
Co-Applicants Information
Full Name:
Account Number:
Email Address:
Contact Phone #:

Loan Information
Type of Loan Applied For:
Personal (Signature)
Share Secured
New Car
Used Car
Amount Requested: $
Proceeds of Loan to be used for:
Length of Loan (# of Months): OR Requested Payment Amount $
Repayment Schedule:
Monthly
Semi-Monthly
Bi-Weekly
Weekly
Repayment Options (When Available):
Payroll Deduction
Automatic Transfer from UECU Account
ACH Debit from Other Financial Institution


Collateral Offered:
Share Account / Share Certificate #: - Amount Pledged $
Title & Insurance to:
Year, Make & Model: VIN:
Name & Phone # of Insurance Agency:

Please indicate your preference on how to sign the lending documents:
Sign Loan Documents at Decatur Facility
Sign Loan Documents at Galesburg Facility
Send Documents to local Sub-Treasurer:
Fax Documents to
E-mail a link to access the documents (Must be printed, signed & faxed back to UECU)
Mail documents to my home
UPS Next Day (expense paid by member)

Options available to expedite receipt of the Proceeds of the Loan (if not finalized at UECU Facility):
Deposit Proceeds to my Share Draft or Money Market Account at UECU.
Forward Proceeds directly to Dealer or Financial Institution.
Deposit Proceeds (via ACH) to my checking account at another credit union or bank (the next business day)

Credit Insurance Election - If you wish to protect yourself and your family in the event of your death, or an extended illness or injury that leaves you disabled beyond 14 days, you may wish to obtain credit insurance. CUNA Mutual Insurance Society offers credit insurance for our members who wish to purchase this insurance.
A Separate insurance election which discloses the terms and conditions must be signed for coverage to become effective.Credit Insurance is voluntary and is not required in order to obtain this loan.
Please check the appropriate boxes below to indicate the coverage option(s) that meets your needs.

Single Credit Disability Insurance   Joint Credit Disability Insurance
Single Credit Life   Joint Credit life Insurance
No, I do not need credit insurance

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


Other Applicants Information
Name:
Account #:
Social Security #:
Birthdate : (MM/DD/YYYY)
Home Phone #:
Cell Phone #:
Physical Address
Street:
City:
State & Zip:
Address Since: (MM/YY)
If less than 3 yrs enter previous address:


Applicants Employment and Income Other Applicants Employment and Income
Employer Name:

Employer Phone #:
Employer Address:

Position:
Date Hired (MM/DD/YY):
Hourly Rate Number Hours Weekly
Annual Gross Income: $

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

Years Employed:

Pension
   Annual or Monthly Income
Social Security
   Annual or Monthly Income

Other (Explain)
   Annual Monthly Income

(NOTICE: Alimony, Child Support, or Separate Maintenance Income need not be revealed if you do not choose to have it considered)
Alimony
    - Monthly Amount $
Child Support
    - Monthly Amount $
Separate Maintenance
    - Monthly Amount $

Alimony, Child Support, or Separate Maintenance received under:
Court Order
Written Agreement
Oral Understanding
Employer Name:

Employer Phone #:
Employer Address:

Position:
Date Hired (MM/DD/YY):
Hourly Rate Number Hours Weekly
Annual Gross Income: $

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

Years Employed:

Pension
   Annual or Monthly Income
Social Security
   Annual or Monthly Income

Other (Explain)
   Annual Monthly Income

(NOTICE: Alimony, Child Support, or Separate Maintenance Income need not be revealed if you do not choose to have it considered)
Alimony
    - Monthly Amount $
Child Support
    - Monthly Amount $
Separate Maintenance
    - Monthly Amount $

Alimony, Child Support, or Separate Maintenance received under:
Court Order
Written Agreement
Oral Understanding

Financial Information
Please list all assets and liabilities.

What You Owe Creditor name other than this credit union
Present Balance Monthly Payment Owed by
  Applicant Other
Rent
1st Mortgage
2nd Mortgage
1st Auto Loan
2nd Auto Loan
401K Loan
Child Support
Credit Card #1
Credit Card #2
Credit Card #3
Credit Card #4
Other #1
Other #2


What You Own Description of property
or name of financial institution
Market
Value
Pledged as collateral for another loan Owned by
  Applicant Other
Home YES NO
Auto #1 YES NO
Auto #2 YES NO
Savings YES NO
Checking YES NO
Other #1 (Describe) YES NO
Other #2 (Describe) YES NO


Applicant Other Applicant
Do you have any outstanding judgements or accounts currently placed with a collection agency?
If 'Yes', please explain below:
Yes No Yes No
Have you filed for bankruptcy or had a debt adjustment plan confirmed under chapter 13 within the past ten years?
If 'Yes', please explain below:
Yes No Yes No
Have you had property foreclosed upon or repossessed in the last 7 years?
If 'Yes', please explain below:
Yes No Yes No
Are you a party in a lawsuit?
If 'Yes', please explain below:
Yes No Yes No
Is your income likely to decline in the next two years?
If 'Yes', please explain below:
Yes No Yes No
Are you a Co-Maker, Co-Signer or Guarantor on any loan not listed above? Yes No Yes No
If Yes, For Whom?
If Yes, Name of the Financial Institution?


Other Information:

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. Interest rates, terms of loan, and loan-to-value granted are determined by your credit worthiness. You do have the right to know your credit score in the event you receive less desirable credit terms. 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 United Equity Credit Union to accept the electronic transmission of this application as your intent to apply for credit as described above, and agree that the electronic transmission will have the same legal force and effect as your physical signature. You assume any risk that may be associated with permitting us to accept your implied signature.

By pressing the "Send Application" button below, you agree to the above statement. You understand that we will require your signature on additional documents prior to disbursing any credit proceeds.


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