LPSCU Loan Application

Loan Application
Applicant is:*
Purpose of loan*
For Vehicle Loan
Amount Requested $*
Term (months)*
Account #*
Co-Borrower?*

YesNo
Borrower*

First NameLast Name
Co-Borrower Name

First NameLast Name
Address*
Address
City, State, Zip*
City, State, Zip
Phone Number*

Area CodePhone Number
Phone Number

Area CodePhone Number
E-mail*
E-mail
Employer*
Employer*
Type a question
I agree that everything stated in this application is correct and I authorize the
credit union to obtain information about my credit history.
I Agree*

Borrower
I Agree*

Co-BorrowerN/A
Should be Empty: