Online Loan Application

Online Loan Application
Personal Information
Amount Requested*
Loan Purpose*
Full Name*

First NameLast Name
Birthdate*

MonthDayYear
Date
SIN
Spouse/Joint Applicant Name

First NameLast Name
Spouse/Joint Applicant Birthdate

MonthDayYear
Date
Spouse/Joint Applicant SIN
Marital Status
No. of Dependants (excluding Spouse)
Age(s) of Dependants
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
I have lived at my present address since*

MonthDayYear
Date
Rent or Own
Rent/Mortgage Payment
Previous Address (if less than 3 years at current address)

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Contact Information
Contact Preference
Contact Time
Email
example@example.com
Phone Number
Please enter a valid phone number.
Personal References
Name

First NameLast Name
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number
Please enter a valid phone number.
Relationship
Name

First NameLast Name
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number
Please enter a valid phone number.
Relationship
Employment Information
Employer Name and Address
How Long?
Occupation
Phone Number
Please enter a valid phone number.
Applicant Salary/Wage
Pay Frequency
Spouse/Joint Applicant Salary/Wage
Pay Frequency
Financial Information

Assets
Asset
Value
Asset
Value
Asset
Value

Liabilities
Liability
Limit/Balance
Monthly Payment
Liability
Limit/Balance
Monthly Payment
Liability
Limit/Balance
Monthly Payment

Will any account/product under this membership be used by and for the benefit of someone other than the named member(s)*

YesNo
Will any accounts/products under this membership be used by a politically exposed foreign person (PEFP)*

YesNo
In relation to my application for credit or obtaining a loan from the Credit Union, I hereby consent to the Credit Union (including any agent, contractor, professional advisor, or collection agent appointed by the Credit Union, and any assignee of the Credit Union) obtaining the disclosure and release of personal information consisting of my current address, telephone number(s), motor vehicle registrations, credit history or banker's credit references, deposit or investment account or credit information, from any provincial or federal government or any government agency or corporation, any financial institution or party that I have an deposit or investment account with or that has granted me credit, or any credit reporting agency. The credit union is authorized by me to obtain this information for the purpose of determining my qualification for credit, confirming the ownership and description of any collateral assets I am providing as security for my loan and registering a security interest in those assets, locating me for the purpose of matters in relation to my loan including the collection of amounts owed, and the seizure of secured assets. This authorization shall remain in force so long as I have a pending credit application before the Credit Union or an amount owing in relation to a loan by the Credit Union to me. (In this authorization "I, me, or my" refers to the applicant under a credit application, or the borrower under a loan or security agreement, and includes single or multiple persons).

I certify that the information on the application is true and I understand that any mis-statement of fact shall entitle the credit union to require immediate payment of all monies advanced under this loan, together with interest.
Date

MonthDayYear
Date
If there is a specific staff member at RCU you would like to deal with, please enter their name here:
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Online Loan Application

Personal Information

Contact Information

Personal References

Employment Information

Financial Information