Loan Information

Income/Expenditure Statement
Monthly Commitments/Expenditure
Bank Loans/Hire Purchase
Rent/Mortgage
Repairs / Maintenance
Food
Clothing
Education
Utilities
Transport-Bus/Car
Insurance Life
Medical Insurance
Insurance Home/Vehicle
Property Tax
Income Tax
N.I.S
Savings
Regular Savings
Credit Union Loan No. 1
Credit Union Loan No. 2
Credit Union Loan No. 3
Credit Union Loan No. 4
Other Commitments
Total Expenditure
Monthly Income
Salary
Pension
Other Income
Total Income
Monthly Net Income (Inc - Exp)
Monthly Net Income
I First Name Last Name hereby give authorization to Ariza Credit Union to process this loan request on my behalf.
Member Signature*

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Reference Information