Loan Application

 


Applicant Account Number
 Amount Requested
Loan Type:
 
Would you like Credit Insurance? Please select a type:
 No credit insurance  
 Single group life  
 Joint group life  
 Group credit Accident & Health  
 Joint Credit Disability  
     


Borrower's Personal Information
First Name
 Initial
 Last Name
Address
   Years at Address
City
 State
 Zip

Social Security Number
Drivers License #
Issuing State

Rent
Own
Date of Birth (mm/dd/yyyy)


Home Phone


Borrower's Employment & Income Information
Current Employer
 Hire Date (mm/dd/yyyy)
  
Position
 Salary
 Salary Frequency

Annual
Current Employer Phone
  Monthly
    Semi-Monthly
    Bi-Weekly
    Weekly


Co-Borrower's Personal Information (If there is no co-borrower, leave blank)
First Name
 Initial
 Last Name
Address
   Years at Address
City
 State
 Zip

Social Security Number
Drivers License #
Issuing State

Rent 		Date of Birth (mm/dd/yyyy)
Home Phone
Own    


Co-Borrower's Employment & Income Information (If there is no co-borrower, leave blank)
Current Employer
 Hire Date (mm/dd/yyyy)
  
Position
 Salary
 Salary Frequency

Annual
Current Employer Phone
  Monthly
    Semi-Monthly
    Bi-Weekly
    Weekly


Credit & Personal References
Mortgage Holder or Landlord
Account Number
Monthly Payment
Current Balance
 
     
Second Mortgage

 Account Number
Monthly Payment
Current Balance
    
     
     
Personal Refence 1

 Address
 City
State
 Zip
 Telephone
     
Personal Refence 2

Address
 City
State
 Zip
 Telephone
     
     
    Have you ever filed bankruptcy?
    YES       NO
     
    Are you a co-maker on any loan?
    YES       NO


I hereby certify that all statements made are true and complete and submitted for the purpose of obtaining credit. In considering this application the loan officer may request and use a report from outside credit reporting agencies. We may also ask a reporting agency or agencies for other such reports in connection with renewal or continuation of the credit for which you are applying. If you request it, we will tell you whether or not we asked for such a report, and if we have the name and address of the agency or agencies as well as how to request a copy for your records will be released to you.

** SOURCE OF OTHER INCOME: Alimony, child support or separate maintenance income need not be revealed if you do not wish to have it considered as a basis for repaying this obligation.

I hereby authorize United Business and Industry Federal Credit Union to request my credit report. This report will only be used to determine my creditworthiness as allowed by law.


I Agree