Credit Union Loan Application

Step 2 of 6 · Applicant
Applicant Information
Full Name

First NameMiddle NameLast Name
Address

Street Address

Street Address Line 2
CityStateZIP Code
Years at this address
Previous address

Street Address

Street Address Line 2
CityStateZIP Code
Social Security Number
Date of Birth

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Email
example@example.com
Home Phone
Please enter a valid phone number.Format: (000) 000-0000.
Cell Phone
Please enter a valid phone number.Format: (000) 000-0000.
Co-Applicant Information
Co-Applicant Full Name

First NameMiddle NameLast Name
Co-Applicant Address

Street Address

Street Address Line 2
CityStateZIP Code
Co-Applicant Years at Address
Co-Applicant Previous Address

Street Address

Street Address Line 2
CityStateZIP Code
Co-Applicant Social Security Number
Co-Applicant Date of Birth

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Co-Applicant Email
example@example.com
Co-Applicant Home Phone
Format: (000) 000-0000.
Co-Applicant Cell Phone
Format: (000) 000-0000.

Step 3 of 6 · Income
Employment and Income
Employer Name
Employer Address

Street Address

Street Address Line 2
CityStateZIP Code
Gross Income
Paid Per
Years on Job
Previous employer
Years at previous employer
Proof of income

Optional. Your two most recent pay stubs, or another document that shows your income.
Cancelof
Co-Applicant Employment
Co-Applicant Employer Name
Co-Applicant Employer Address

Street Address

Street Address Line 2
CityStateZIP Code
Co-Applicant Gross Income
Co-Applicant Paid Per
Co-Applicant Years on Job
Co-Applicant Previous Employer
Co-Applicant Years at Previous Employer
Co-applicant proof of income

Optional. Two most recent pay stubs, or another document that shows income.
Cancelof
Other Income
Alimony, child support, or separate maintenance income need not be revealed if you do not wish to have it considered as a basis for repaying this obligation.
Other Income Source
Other Income Amount

Step 5 of 6 · Loan Protection
Loan Protection
Credit insurance is voluntary and doesn’t affect your loan approval. Let us know if you’d like to learn more. If you’re interested, we’ll send a separate application that explains the terms, conditions and cost before any coverage starts.
Member’s Choice Life Insurance

Credit life insurance can pay off or pay down your loan balance if you pass away. It’s voluntary and isn’t required to get this loan.
Are you interested in credit life insurance?
Credit Disability Insurance

Credit disability insurance can make your loan payments if you become disabled and can’t work. It’s voluntary and isn’t required to get this loan.
- - The policy is a contract between you and CMFG Life Insurance Company. You’re responsible for all loan payments regardless of coverage.
  - Before filing a claim, you must be off work and under a doctor’s care for 30 days. Then you contact the credit union, and the insurance company mails you a claim form for you and your doctor to complete. Some doctors charge a fee for the form, which you would pay.
  - Pre-existing conditions are not covered. Examples include high blood pressure, heart attack, stroke, cancer, back trouble, gout, asthma, epilepsy, nervous breakdown and emphysema.
  - The credit union may keep a portion of the insurance charge.
- Are you interested in credit disability insurance?
- Collateral Insurance
  
  In consideration for the granting of the loan applied for, I agree to keep the collateral insured at all times against loss, theft, and damage under a policy of insurance which provides for payment to the Electrical Workers 558 Federal Credit Union in the event of loss covered by the policy. I will keep the insurance in force for the term of the loan, and any extensions or renewals thereof.
- Collateral insurance agreement
- Insurance agent or company
  Optional. We can collect this at closing.
- Agent phone
  Format: (000) 000-0000.

Step 6 of 6 · Review & Sign
Review Your Application
Check your answers before you sign. To change something, select Back.

Loan Request

Loan type	{loanType}
Amount requested	${q3_number1}
Purpose of loan	{q4_textbox2}
New or used	{vehicleCondition}
Purchase or refinance	{purchaseOrRefinance}
Vehicle or equipment	{vehicleYear} {vehicleMake} {vehicleModel}
VIN or serial number	{vehicleVin}
Mileage or hours	{vehicleMileage}
Purchase price	${purchasePrice}
Down payment	${downPayment}
Buying from	{sellerType}
Secured by	{securedBy}
Property is current home	{propertyIsHome}
Property address	{propertyAddress:addr_line1}{propertyAddress:addr_line2}{propertyAddress:city}, {propertyAddress:state} {propertyAddress:postal}
Estimated property value	${propertyValue}
Account number	{q6_textbox4}
Co-applicant	{q8_radio6}

Applicant Information

Name	{q13_fullname11}
Address	{q14_address12:addr_line1}{q14_address12:addr_line2}{q14_address12:city}, {q14_address12:state} {q14_address12:postal}
Years at this address	{yearsAtAddress}
Previous address	{previousAddress:addr_line1}{previousAddress:addr_line2}{previousAddress:city}, {previousAddress:state} {previousAddress:postal}
Social Security number	{q15_textbox13}
Date of birth	{q16_datetime14}
Email	{q17_email15}
Home phone	{q18_phone16}
Cell phone	{q19_phone17}

Name	{q23_fullname21}
Address	{q24_address22:addr_line1}{q24_address22:addr_line2}{q24_address22:city}, {q24_address22:state} {q24_address22:postal}
Years at this address	{coYearsAtAddress}
Previous address	{coPreviousAddress:addr_line1}{coPreviousAddress:addr_line2}{coPreviousAddress:city}, {coPreviousAddress:state} {coPreviousAddress:postal}
Social Security number	{q25_textbox23}
Date of birth	{q26_datetime24}
Email	{q27_email25}
Home phone	{coapplicantHome}
Cell phone	{coapplicantCell}

Employment and Income

Employer	{q29_textbox27}
Employer address	{q30_address28:addr_line1}{q30_address28:addr_line2}{q30_address28:city}, {q30_address28:state} {q30_address28:postal}
Gross income	${q31_number29}
Paid per	{q32_dropdown30}
Years on job	{q33_number31}
Previous employer	{previousEmployer}
Years at previous employer	{previousEmployerYears}
Proof of income	{incomeDocs}
Other income source	{q41_textbox39}
Other income amount	${q42_number40}

Employer	{q35_textbox33}
Employer address	{q36_address34:addr_line1}{q36_address34:addr_line2}{q36_address34:city}, {q36_address34:state} {q36_address34:postal}
Gross income	${q37_number35}
Paid per	{q38_dropdown36}
Years on job	{q39_number37}
Previous employer	{coPreviousEmployer}
Years at previous employer	{coPreviousEmployerYears}
Proof of income	{coIncomeDocs}

Debts

Own or rent	{q45_radio43}
Mortgage balance	${q46_number44}
Monthly housing payment	${q47_number45}
Other debtsCreditor, balance, monthly payment	{q48_widget_ConfigurableList46}

Own or rent	{q50_radio48}
Mortgage balance	${q51_number49}
Monthly housing payment	${q52_number50}
Other debtsCreditor, balance, monthly payment	{q53_widget_ConfigurableList51}

Credit History

Bankruptcy (Chapter 7 or 13)	{q55_radio53}
Property foreclosed or repossessed	{q56_radio54}
Outstanding judgments	{q57_radio55}
Co-maker or co-signer on another loan	{q58_radio56}

Explanation of Yes Answers

Explanation {q63_textarea61}

Bankruptcy (Chapter 7 or 13)	{q59_radio57}
Property foreclosed or repossessed	{q60_radio58}
Outstanding judgments	{q61_radio59}
Co-maker or co-signer on another loan	{q62_radio60}

Explanation	{q63_textarea61}

Loan Protection

Credit life insurance	{creditLife}
Credit disability insurance	{creditDisability}
Collateral insurance	{collateralAgree}
Insurance agent or company	{insuranceAgent}
Agent phone	{insuranceAgentPhone}

Certification and Signatures
I hereby certify that all of the statements made are complete and correct. I authorize the Credit Union to verify my employment and to obtain and release credit information in connection with this application and any update, renewal or extension of any credit received. At my request, you will give me the name and address of the Credit Bureau(s) used. I understand that it is a Federal crime to willfully and deliberately provide incomplete or incorrect information on a loan application made to a Federal Credit Union.
Electronic signature
Credit check
Co-applicant electronic signature
Co-applicant credit check
Applicant Signature
Signature Date

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Co-Applicant Signature
Co-Applicant Signature Date

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Should be Empty:

Loan Application

Loan Information

About the vehicle or equipment

Applicant Information

Co-Applicant Information

Employment and Income

Co-Applicant Employment

Other Income

Debts

Co-Applicant Debts

Credit History

Co-Applicant Credit History

Loan Protection

Member’s Choice Life Insurance

Credit Disability Insurance

Collateral Insurance

Review Your Application

Loan Request

Applicant Information

Co-Applicant Information

Employment and Income

Co-Applicant Employment

Debts

Co-Applicant Debts

Credit History

Co-Applicant Credit History

Explanation of Yes Answers

Loan Protection

Certification and Signatures