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Loan Application

USA Patriot Act

IMPORTANT INFORMATION ABOUT PROCEDURES FOR OPENING A NEW ACCOUNT

To help the government fight the funding of terrorism and money laundering activities, Federal law requires all financial institutions to obtain, verify, and record information that identifies each person who opens an account.

What this means for you: When you open an account, we will ask for your name, address, date of birth, and other information that will allow us to identify you. We may also ask to see your driver's license or other identifying documents. 


* Required Fields
Application Type:
Please Tell Us About Yourself (Primary Borrower)
Your Vehicles
Vehicle 1
Vehicle 2
Have you ever filed Bankruptcy?
Date, if yes:
 /   / 
Are you a co-maker on other loans:
Social Security Number:
 -   - 
Birth Date:
 /   / 
Are you a U.S. Citizen:
Please Tell Us About Your Job (Primary Borrower)
Hire Date:
 /   / 
Monthly dollar amount that you receive in alimony, child support, or separate maintenance - this income need not be revealed if you do not wish to have it considered as a basis for repaying this obligation

The following information pertains to CO-BORROWER.

Please Tell Us About Yourself (Co-Borrower)

Co-borrower Signature:
Social Security Number:
 -   - 
Birth Date:
 /   / 
Your Vehicles
Vehicle 1
Vehicle 2
Please Tell Us About Your Job (Co-Borrower)
Hire Date:
 /   / 
Monthly dollar amount that you receive in alimony, child support, or separate maintenance - this income need not be revealed if you do not wish to have it considered as a basis for repaying this obligation
Please List Nearest Relative Not Living With You
Please List An Additional Relative Not Living With You
Please List An Additional Relative Not Living With You
Statement of Total Indebtedness and Liabilities
Mortgage or Rent
Auto Loan
Credit Union
Bank
Credit Card
Credit Card
Other
Child Support / Alimony / Separate Maintenance

Click the "I accept the terms of the disclaimer above and submit my application" button to send the application to us via the WWW after reading the disclaimer below.  By clicking "I accept the terms of the disclaimer above and submit my application", you accept the terms of the disclaimer below.

DISCLAIMER: 
I/WE HEREBY CERTIFY THAT ALL STATEMENTS MADE ARE TRUE AND COMPLETE, ARE SUBMITTED FOR THE PURPOSE OF OBTAINING CREDIT, AND THAT THE CREDIT UNION MAY RELY ON THEM FOR SUCH DETERMINATION.  I/WE AUTHORIZE YOU TO OBTAIN SUCH INFORMATION AS YOU MAY REQUIRE CONCERNING THE STATEMENTS MADE IN THIS APPLICATION, AND AGREE THAT THE APPLICATION SHALL REMAIN YOUR PROPERTY, AND YOU ARE AUTHORIZED TO ANSWER QUESTIONS ABOUT YOUR CREDIT EXPERIENCE WITH ME/US.

Federal law requires verification of valid identification on all new accounts. As a loan is included in the definition of a new account, please be prepared to show valid identification.

A $15.00 loan application fee may be assessed.

I accept:
Security Code:

Equal Housing Lender National Credit Union Administration
NCUA - Your savings federally insured to at least $250,000 and backed by the full faith and credit of the United States Government. National Credit Union Administration, a U.S. Government agency. Equal Housing Lender - We do business in accordance with the Fair Housing Law and Equal Opportunity Credit Act