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Important Information About Procedures for Applying for a Loan
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 or business that opens an account.
What this means for you: When you open an account, we will ask for your name, address, date of birth, if applicable, and other information that will allow us to identify you.
We may also ask to see your driver's license or other identifying documents.
Married Applicants may apply for a separate account.
Member/Account Number:
*
Type of Credit:
*
Individual/Business
Joint (Co-Applicant must individually complete Co-Applicant Information)
Amount Requested:
*
Purpose of Loan:
*
Applicant/Individual Information
Business/Individual Name
*
Year Business Established
*
State
*
Alabama
Alaska
American Samoa
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Guam
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Northern Mariana Islands
Ohio
Oklahoma
Oregon
Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
U.S. Virgin Islands
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Armed Forces Americas
Armed Forces Europe
Armed Forces Pacific
State
DBA Name(s)
Prior Business Name(s)
Contact Name
*
First
Last
Title
Telephone
*
Type of Organization:
*
Individual
Sole Proprietorship
Partnership
Corporation
LLC
Association
Non-Profit
Other
Employer Name:
Employer Telephone Number
SSN/TIN Number
Driver's License Number
DL State
Alabama
Alaska
American Samoa
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Guam
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Northern Mariana Islands
Ohio
Oklahoma
Oregon
Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
U.S. Virgin Islands
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Armed Forces Americas
Armed Forces Europe
Armed Forces Pacific
State
DL Issuance Date
Month
Day
Year
DL Expiration Date
Month
Day
Year
Date of Birth
*
Month
Day
Year
Home Telephone
Work Telephone
Cell Phone
Fax Number
Website Address
Email Address
*
Physical Address
*
Street Address
City
Alabama
Alaska
American Samoa
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Guam
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Northern Mariana Islands
Ohio
Oklahoma
Oregon
Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
U.S. Virgin Islands
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Armed Forces Americas
Armed Forces Europe
Armed Forces Pacific
State
ZIP Code
Complete for Joint Credit, Secured Credit, or if you live in a community property state:
*
Married
Separated
Unmarried (Single - Divorced - Widowed)
ID Verification:
Guarantor/Co-Applicant
Do you have a Guarantor or Co-Applicant?
*
Yes
No
Guarantor/Co-Applicant Information
I am providing the following information for purposes of serving as a:
SSN/TIN Number
Date of Birth
Name
Driver's License Number
State
DL Issuance Date
DL Expiration Date
Home Telephone
Work Telephone
Cell Phone
Fax Number
Website Address
Email Address
Physical Address
Complete for Joint Credit, Secured Credit, or if you live in a community property state:
ID Verification
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Sources of Income
Important Notice to Individuals
Alimony-Child Support:
The inclusion of alimony, separate maintenance, or child support as income is voluntary and need not be revealed if you do not wish to have it considered in evaluating this application.
Applicant Income
Net Sales
Base Salary
Overtime
Bonus and/or Commission
Dividends/Interest
Net Rental Income
Itemized Other Income
Other Source of Income
Amount
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Applicant Gross Annual Income Total
Guarantor or Co-Applicant #1 Income
Net Sales
Base Salary
Overtime
Bonus and/or Commissions
Dividends/Interest
Net Rental Income
Itemized Other Income
Other Source of Income
Amount
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Guarantor or Co-Applicant #1 Income Total
Guarantor or Co-Applicant #2 Income
Net Sales
Base Salary
Overtime
Bonus and/or Commissions
Dividends/Interest
Net Rental Income
Itemized Other Source of Income
Other Source of Income
Amount
Actions
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Guarantor or Co-Applicant #2 Income Total
Spouse Income (If Applicable)
Net Sales
Base Salary
Overtime
Bonus and/or Commissions
Dividends/Interest
Net Rental Income
Itemized Other Source of Income
Other Source of Income
Amount
Actions
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Spouse Income Total
Sources of Income Totals
Total Annual Income for all Sources
Financial Information
Please include copies of the following checked items as attachments to this application:
Financial Documents
Federal Tax Return For:
Current Year
Borrower
Guarantor/Co-Applicant(s)
Other
Other Federal Tax Return
Other Federal Tax Return
Borrower
Guarantor/Co-Applicant(s)
Balance Sheet for Current Year for:
Borrower
Guarantor/Co-Applicant(s)
Income Statement for Current Year for:
Borrower
Guarantor/Co-Applicant(s)
Financial Services Accounts Information
Loan(s)
Borrower
Guarantor/Co-Applicant(s)
Other Accounts
Type of Other Accounts
Borrower
Guarantor/Co-Applicant(s)
Additional Account Information
Check if additional account information accompanies this application.
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Max. file size: 400 MB.
Signatures
You promise that everything you have stated in this application is correct to the best of your knowledge and that the above information is a complete listing of what you owe. If there are any important changes you will notify us in writing immediately. You authorize the Credit Union to obtain credit reports in connection with this application for credit and for any update, increase, renewal, extension or collection of the credit received. You understand that the Credit Union will rely on the information in this application and your credit report to make its decision. You agree that requested documentation that accompanies this application is complete and correct and that it's incorporated as part of this application. If you request, the Credit Union will tell you the name and address of any credit bureau from which it received a credit report on you. It is a crime to willfully and deliberately provide incomplete or incorrect information in this application. The person(s) signing the application is/are indeed authorized to act on behalf of the borrower. Borrower, co-applicant(s), and guarantor(s), as appropriate grants to the credit union the authority to use reasonable means to verify application information by requesting credit bureau reports, accessing information about borrower, co applicant(s), and guarantor(s), as appropriate from other third party information providers, and other means if applicable.
Borrower further grants to credit union the right to share this information with third parties as reasonable in the normal course of doing commercial lending including sharing this information with a third party for purposes of underwriting the loan. Borrower agrees to pay any fees charged by the credit union for processing this application and other related expenses whether the application is approved or denied. You promise that the credit you are applying for is for a business purpose. By signing below or by using your card, you understand that either of those actions will constitute acknowledgment of receipt and agreement to the terms of the credit card agreement and disclosures.
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By:
Date
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Comments
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