umembers Home Page

Secure Loan Application Form

4833 S. Sheridan Suite 401, Tulsa, OK  74145
Phone: (918) 663-9303  •  Fax: (918) 663-9305
   
Type Of Loan Applying For

Married applicants may apply for a separate account. If you arwe applying for Individual Credit, you must complete the Applicant section about yourself and the Joint Applicant section about your spouse if:

  • Your spouse will use the account, or
  • You are relying on your spouse's income as a basis for repayment.

If you are relying on income from alimony, child support or separate maintenance, complete the Joint Applicant section to the extent possible about the person on whose payments you are relying.

If you are applying for Joint Credit with another person, complete the Applicant and Joint Applicant sections.
Member Number:
You must be a United Members Federal Credit Union member to apply for a loan.
Is this your first loan from us? Yes No
Amount/Credit Limit Requested: $
Approximate Time to Repay: How Many: Periods:
Loan Type:
Purpose of loan:
Security Offered: (for secured credit only)
Are you submitting individually or jointly?


Payment Protection Coverage
Check If Desired

Find out more about Payment Protection Insurance and why it's a better consumer value when offered through your credit union.

Check coverage(s) desired. We will disclose the cost of this Payment Protection Insurance - Credit Disability and Credit Life - to you. A separate enrollment form which discloses the terms and conditions must be signed for coverage to become effective.

Yes - Do you want your loan protected for you and your family if you become disabled?
No



Applicant Information
Applicant's Name:
Social Security #:
Email:
US Citizen: Yes No
Birthdate (MM/DD/YYYY):
Home Phone #:
Cell Phone #:
Street Address:
City: State:
Zip #:
Rent/Own/Buying:
   Payment Amount:
Current Address since: (MM/YY)
If less than 2 yrs enter previous address:
Joint Applicant Type:   
Joint Applicant's Name:
Account #:
Social Security #:
Email:
US Citizen: Yes No
Birthdate (MM/DD/YYYY):
Home Phone #:
Cell Phone #:
Street Address:
City: State:
Zip #:
Rent/Own/Buying:
Payment Amount:
Current Address since: (MM/YY)
If less than 2 yrs enter previous address:


Employment Information
Applicant Employer's Name:
Employer Phone #:
Employer Address:
Position:
Are you self employed?
Type of Business
Date Hired (MM/DD/YY):
Monthly Gross Income ($):
Other Income ($): per Month
Complete if current employment is less than 2 years:
Previous Employers Name:
Yrs Employed:
Joint App. Employer's Name:
Employer Phone #:
Employer Address:
Position:
Are you self employed?
Type of Business
Date Hired (MM/DD/YY):
Monthly Gross Income ($):
Other Income ($): per Month
Complete if current employment is less than 2 years:
Previous Employers Name:
Yrs Employed:
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
Lender
Type
Balance
Min. Pmt.
$ .00
$ .00
$ .00
$ .00
$ .00
$ .00
$ .00
$ .00
$ .00
$ .00
$ .00
$ .00
$ .00
$ .00
$ .00
$ .00
$ .00
$ .00
Child Support Payments / Alimony $
Assets:
Description: Value:
    
Description: Value:
    
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?
   Is your income likely to decline in the next two years?
Are you co-maker/endorser on any loan not listed above?
   If yes then for whom?
   If yes then to whom?

References
First Name: Middle Name: Last Name: Suffix:
   Home Phone Number:
   555-555-5555
   What is their home address?
Street: City: State: Zip:
   What is the relationship?


Contact Method
  How would you prefer to be contacted? Home Phone Cell Phone Email
 
  Additional Comments:


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 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.

Note: A current wage stub showing year-to-date information, or other income documentation will be required for loan processing. Please fax this to (918) 663-9305 after submitting your loan application.

By pressing the "Submit 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.