Master Application
NOTICE TO MARRIED APPLICANTS: YOU HAVE THE RIGHT TO APPLY FOR A SEPARATE ACCOUNT IN YOUR NAME
Check Type of Credit Requested
Individual Credit: Complete sections A, B, D, E and F if only the applicant's income is considered for loan approval. Complete sections A, B, C, D, E and F (1) if you are relying on income from alimony, child support, or separate maintenance or on the income or assets of another person as the basis for repayment of the credit requested, or; (2) if you reside in a Community Property State, or; (3) if you are relying on property located in a Community Property State as a basis for repayment of the credit requested. Community Property States include: AK, AZ, CA, ID, LA, NM, NV, TX,WA, and WI.
Joint Credit: Complete sections A, B, C, D, E and F if your co-applicant will be contractually liable for repayment of the loan and initial below: We intend to apply for joint credit.
(Applicant Initials)
*
(Co-Applicant Initials)
I/We Would Like A Loan Of $
*
For The Following Purpose
Security Offered
*
Account Number
Credit Type
Visa
Joint
Individual
Number of Cards:
If Authorized User, Name
A. Applicants Personal Information
CHECK ONE IF YOU RESIDE IN OR ARE RELYING ON PROPERTY IN A COMMUNITY PROPERTY STATE OR IF YOU ARE APPLYING FOR OTHER THAN INDIVIDUAL UNSECURED CREDIT.
Married
Unmarried
Separated
Name (First, Middle Initial, Last)
*
First Name
Middle Initial
Last Name
Date of Birth
*
/
Month
/
Day
Year
Date
Social Security No.
*
Email
example@example.com
Present Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
How Long?
Phone Number
-
Area Code
Phone Number
Age of Dependents
Previous Address (Street, City, State, Zip)
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
How Long
Driver's License No. And State
B. Information Regarding Applicant
Present Employer
*
Employer's Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Employment Length
Occupation
*
Supervisors Name
*
Work Phone and Ext.
-
Area Code
Phone Number
Monthly Gross Pay $
*
Please upload your two most current paystubs here
*
Browse Files
Cancel
of
Previous Employer
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
How Long?
Occupation
Own or Rent
Payment Amount $
Date Purchased
/
Month
/
Day
Year
Date
Purchase Price
Value
OTHER INCOME NOTICE:
Do not list alimony, child support or separate maintenance payments unless you wish them considered as a basis for repayment of the credit requested. If listed, verification may be required.
Source of Other Income
Amount $
Total Monthly Income $
C. Information Regarding
Co-Applicant
Non-Applicant Spouse/Other
Guarantor
Name
First Name
Middle Initial
Last Name
Date of Birth
-
Month
-
Day
Year
Date
Email
example@example.com
Social Security No.
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Home Phone Number
-
Area Code
Phone Number
Driver's License No. And State
Present Employers Name and Address (City, State, Zip)
Occupation
Work Phone and Ext
-
Area Code
Phone Number
Employment Length
Monthly Gross Pay $
OTHER INCOME NOTICE:
Do not list alimony, child support or separate maintenance payments unless you wish them considered as a basis for repayment of the credit requested. If listed, verification may be required.
Source of Other Income
Amount $
Total Monthly Income
D. LIST ALL EXISTING DEBTS OF APPLICANT
(AND CO-APPLICANT, NON-APPLICANT SPOUSE /OTHER IF ANY PART OF SECTION C IS APPLICABLE)
Name and address of creditor
Purpose or Acct. #
Original Amount
Present Balance
Monthly Payment
1
2
3
4
5
6
7
8
9
DO NOT OMIT ANY DEBTS! IF MORE SPACE IS NEEDED, USE SEPARATE SHEET. INCOMPLETE APPLICATIONS CANNOT BE PROCESSED.
If you answer “yes” to any of these Questions, provide details on page 2.
ARE ANY OF YOUR DEBTS PAST DUE?
Yes
No
HAVE YOU EVER HAD YOUR AUTO, FURNITURE OR PROPERTY REPOSSESSED?
Yes
No
HAVE YOU OR YOUR CO-APPLICANT EVER DECLARED BANKRUPTCY?
Yes
No
ARE YOU CURRENTLY A CO-MAKER ON A LOAN?
Yes
No
E. Financial Information and References
Bank Name
Type of Account
Checking
Savings
CD's
Bank Name
Type of Account
Checking
Savings
CD's
Name of Relative not living with you
Name
First Name
Middle Initial
Last Name
Present Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
-
Area Code
Phone Number
Relationship
Personal Reference not related to applicant
Name
First Name
Middle Initial
Last Name
Present Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
-
Area Code
Phone Number
F. Vehicle Information
Please enter the following information if applying for a Auto Loan
Make
Ford
Model
F150
Year
2018
Mileage
123456
VIN
abcd1234dcba4321a
Credit Life and Credit Disability Insurance is available to protect your loan. Credit Life Insurance can reduce or pay off your loan if you die. Credit Disability Insurance can help make your loan payments if you should become disabled and unable to work
I am interested in applying for the insurance coverage(s) checked below. I understand that this is not an application for insurance. This insurance is voluntary and is not a condition for approval of my loan or credit plan. I understand that the cost will be disclosed on my Truth-in-Lending Disclosure Statement. Insurance coverage will become effective after I apply and meet the eligibility requirements of the group policies when my loan or credit plan is approved.
I would like information on the insurance coverage(s) checked below.
Single Credit Life
Joint Credit Life
Credit Disability
Loan Application Signatures
PLEASE READ BEFORE SIGNING:
All the information in this application is true. I understand that section 1014 Title 18 U.S. Code makes it a federal crime to knowingly make a false statement on this application. You have my permission to check it. You may retain this application even if not approved. I understand that you may receive information from others about my credit and you may answer questions and requests from others seeking credit or experience information about me or my accounts with you. If this application is approved, I agree to honor the provisions of the credit or loan agreement and security agreement covering my account or loan. (If this application is for two of us, this statement applies to both of us.
IMPORTANT NOTICE 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 me: When I open an account, you will ask for my name, address, date of birth, and other information that will allow you to identify me. You may also ask to see my driver's license or other identifying information.
Signature of Applicant
*
Date
/
Month
/
Day
Year
Date
Signature of Co-Applicant
Date
/
Month
/
Day
Year
Date
HAVE YOU OMITTED ANYTHING? REMEMBER: INCOMPLETE APPLICATIONS CANNOT BE PROCESSED.
Additional Comments
For Credit Union Use Only
Loan Officer:
Approved
Rejected
Referred to Credit Committee
Reason
Loan Officer Signature
Date
/
Month
/
Day
Year
Date
Loan Officer:
Approved
Rejected
Reason
Loan Officer Signature
Date
/
Month
/
Day
Year
Date
Loan Officer Signature
Date
/
Month
/
Day
Year
Date
Loan Officer Signature
Date
/
Month
/
Day
Year
Date
ECOA Notice Sent or Delivered On
/
Month
/
Day
Year
Date
By
Submit
Should be Empty: