FFCU Christmas Loan Application

Name

First NameLast Name

Phone Number

Format: (000) 000-0000.

Email

Preferred Contact Method

Are you already a Florence Federal Credit Union member?

Address

Street Address

Street Address Line 2

CityState

Zip Code

Do you rent or own your current residence?

What is your current monthly payment?

Amount Requested

Date Needed by

Date

How did you hear about our Christmas Loan Program?

Employment Information

Company Name

Phone Number

Format: (000) 000-0000.

Length of Employment

Payment Frequency

Please attach a copy of your most recent pay-stub.

Agreement

By signing this application you acknowledge 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 agree to notify the Credit Union 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. If you request, the Credit Union will relay the name and address of any credit bureau from which a credit report was provided. It is a crime to willfully and deliberately provide incomplete or incorrect information in this application.

Signature

Date