TENNESSEE DEPT OF SAFETY CREDIT UNION LOAN LINER APPLICATION

TENNESSEE DEPT OF SAFETY CREDIT UNION

Loanliner Application
Individual Credit: You must complete the Applicant section about yourself and the Other section about your spouse if: 1. you live in or the property pledged as collateral is located In a community property state (AK, AZ, CA, ID, LA, NM, NV, TX, WA, WI), 2. your spouse will use the account, or 3. you are relying on your spouse's income as a basis for repayment. If you are relying on income from alimony, child support, or separate maintenance, complete the Other section to the extent possible about the person on whose payments you are relying.

Joint Credit: Each Applicant must Individually complete the appropriate section below. If Co-Borrower is spouse of the Applicant, mark the Co-Applicant box. Guarantor: Complete the Other section if you are a guarantor on an account/loan.
Check below to indicate type of account(s) and type of credit for which you are applying. Married Applicants may apply for a separate account.
Loanliner Account/Loan*

IndividualJoint
Amount Requested*
Purpose/Collateral*
Repayment*
Are you interested In having your loan protected?*

YesNo
If you answer "yes", the credit union will disclose the cost to protect your loan. The protection is voluntary and does not affect your loan approval. In order for your loan to be covered, you will need to sign a separate application that explains the terms and conditions.
Applicant
Name*

First NameMiddle NameLast Name
Account Number
Social Security Number*
Drivers License Number
State Issued

Street Address

Street Address Line 2

CityState

Zip Code
Date of Birth*

MonthDayYear
List of ages of dependents not listed by other applicant (Exclude Self)
Home Phone Number
Please enter a valid phone number.
Cell Phone Number*
Please enter a valid phone number.
Business Phone Number
Please enter a valid phone number.
Email
example@example.com
Current Address*

Street Address

Street Address Line 2

CityState

Zip Code
Do you own or rent this property?

OwnRent
Years at this address
Previous Address

Street Address

Street Address Line 2

CityState

Zip Code
Do you own or rent this property?

OwnRent
Years at this address
COMPLETE FOR JOINT CREDIT, SECURED CREDIT OR IF YOU LIVE IN A COMMUNITYPROPERTY STATE:
Current Employment
Employer Information*
Income

NOTICE: ALIMONY, CHILD SUPPORT, OR SEPARATE MAINTENANCE INCOME NEED NOT BE REVEALED IF YOU DO NOT CHOOSE TO HAVE IT CONSIDERED.
Employment Income
$ blanks per blank
Calculated

NetGross
Other Income
$ blanks per blank
Other Income Source
Military: Is duty station transfer expected during the next year? blanks . Where? blank. Ending/Separation date? .
Please upload proof of income. (max file size 10854 KB)

Cancelof
Previous Employment
Previous Employer Information (if employed less than 5 years)
References
Reference 1: Nearest relative not living with you.
Name

First NameLast Name
Address

Street Address

Street Address Line 2

CityState

Zip Code
Phone Number
Please enter a valid phone number.
Relationship to you
Reference 2: Nearest relative not living with you.
Name

First NameLast Name
Address

Street Address

Street Address Line 2

CityState

Zip Code
Phone Number
Please enter a valid phone number.
Relationship To You
Co-Applicant
Name

First NameMiddle NameLast Name
Account Number
Social Security Number
Drivers License Number
State Issued

Street Address

Street Address Line 2

CityState

Zip Code
Date of Birth

MonthDayYear
List of ages of dependents not listed by other applicant (Exclude Self)
Home Phone Number
Please enter a valid phone number.
Cell Phone Number
Please enter a valid phone number.
Business Phone Number
Please enter a valid phone number.
Email
example@example.com
Current Address

Street Address

Street Address Line 2

CityState

Zip Code
Do you own or rent this property?

OwnRent
Years at this address
Previous Address

Street Address

Street Address Line 2

CityState

Zip Code
Do you own or rent this property?

OwnRent
Years at this address
COMPLETE FOR JOINT CREDIT, SECURED CREDIT OR IF YOU LIVE IN A COMMUNITYPROPERTY STATE:
Co-Applicant Current Employment
Employer Information
Co-Applicante Previous Employment
Previous Employer Information (if employed less than 5 years)

Debts

	Creditor Name	Interest Rate	Present Balance	Monthly Payment	Owned By
Rent
1st Mortgage
2nd Mortgage
1st Auto Loan
2nd Auto Loan
Child Care
Child Support
Credit Card
Credit Card
Other
Other
Totals

Assets

	Financial Institution or Location of Property	Market Value	Pledged as Collateral	Owened by
Home
Auto
Savings
Checking
Other (describe)

Other Information
Are you a U.S. citizen or permanent resident alien?
Is the co-applicant a U.S. citizen or permanent resident alien?
Do you currently have any outstanding judgements or have you ever filed for bankruptcy, had a debt adjustment plan confirmed under Chapter 13, had property forclosed upon or repossessed in the last 7 years, or been a party in a lawsuit? If yes to any, please explain below.
Has the co-appliant had any outstanding judgements or have you ever filed for bankruptcy, had a debt adjustment plan confirmed under Chapter 13, had property forclosed upon or repossessed in the last 7 years, or been a party in a lawsuit? If yes to any, please explain below.
Is your income likely to decline in the next two years? If yes to any, please explain below.
Is the co-appliant's income likely to decline in the next two years? If yes to any, please explain below.
Are you a co-maker, co-signer, or guarantor on any loan not listed above? If yes to any, please describe loan and creditor below.
Is the co-appliant a co-maker, co-signer, or guarantor on any loan not listed above? If yes to any, please describe loan and creditor below.
Please clarify any of your "yes" answers above.
State Law Notices
OHIO RESIDENTS ONLY: The Ohio laws against discrimination require that all creditors make credit equally available to all creditworthy customers, and that credit reporting agencies maintain separate credit histories on each individual upon request. The Ohio Civil Rights Commission administers compliance with this law.

WISCONSIN RESIDENTS ONLY: (1) No provision of any marital property agreement, unilateral statement under Section 766.59, or court decree under Section 766.70 will adversely affect the rights of the Credit Union unless the Credit Union Is furnished a copy ol the agreement. statement or decree. or has actual knowledge of its terms before the credit ls granted or the account is opened. (2) Please sign If you are not applying for this account or loan with your spouse. The credit being applied for, if granted, will be Incurred in the interest of the marriage or family of the undersigned.
Signature for Wisconsin Residents Only

Clear
Date Signed

MonthDayYear
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, renewal or extension 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 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.
Applicant's Signature*

Clear
Date Signed

MonthDayYear
Co-Applicant's Signature

Clear
Date Signed

MonthDayYear
Should be Empty:

TENNESSEE DEPT OF SAFETY CREDIT UNION

Applicant

Current Employment

Income

Previous Employment

References

Co-Applicant

Co-Applicant Current Employment

Co-Applicante Previous Employment

Other Information

State Law Notices

Signatures