Complete the following application for both the applicant and co-applicant. Then click the "Submit Form" button at the bottom of the page. A "Form Confirmation Page" will appear; verify the information submitted. If the information is correct, click "Return to the form" at the bottom of the page. If you notice an error, return to the form, correct the error and submit the form again. That's it. Thank you for thinking of us for your borrowing needs.
Applicant
We offer payment protection products which protect your financial responsibility should you get injured and miss more than seven days of work. During your recovery, your payment will be made from the first day you were unable to work, thereby protecting your savings. We also offer life protection which will pay the entire remaining balance of your loan in the event of your death. Please check the coverage(s) desired. A separate enrollment form which discloses the terms and conditions must be signed for coverage to become effective.
Do you want your loan protected for you and your family if you become disabled?
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Yes
No
Do you want your loan protected for you and your family in the event of your death?
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Yes
No
First Name
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Last Name
*
Address
*
City, State, Zip
*
Home Phone
*
E-Mail Address
Date of Birth
*
Social Security Number
*
Purpose of the loan
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New Auto
Used Auto
Unsecured
Recreational Vehicle
Security (vehicle make, model, year, etc...)
If you're purchasing from a dealer, please list the dealership.
Loan Amount $
*
Employer
Job Title
Start Date (mm/yy)
Monthly Income
Other Income (Rent, Child Support, etc...)
Source of other income
Marital Status
Married
Unmarried
Separated
If married, please complete spouse information in Co-Applicant fields below.
Type of home ownership
Own
Rent
Monthly Housing Payment
Preferred method of contact
e-mail
phone
regular mail
Do you have any outstanding judgments?
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Yes
No
Have you ever filed for Bankruptcy or had a debt adjustment plan confirmed under Chapter 13?
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Yes
No
Have you had property foreclosed upon or repossessed in the past 7 years?
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Yes
No
Are you a party in a lawsuit?
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Yes
No
Are you other than a U.S. citizen or permanent resident alien?
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Yes
No
Is your income likely to decline in the next two years?
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Yes
No
Are you a co-maker, co-signer, or guarantor on any loan?
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Yes
No
(If YES) For whom? (name of the other obligated on the loan).
Co-Applicant: (Spouse or Joint Borrower)
First Name
Last Name
Address
City, State, Zip
Home Phone
E-Mail Address
Date of Birth
Social Security Number
Employer
Job Title
Start Date
Monthly Income
Other Income (Rent, Child Support, etc...)
Source of Income
Preferred method of contact
e-mail
phone
regular mail
Do you have any outstanding judgments?
Yes
No
Have you ever filed for Bankruptcy or had a debt adjustment plan confirmed under Chapter 13?
Yes
No
Have you had property foreclosed upon or repossessed in the past 7 years?
Yes
No
Are you a party in a lawsuit?
Yes
No
Are you other than a U.S. citizen or permanent resident alien?
Yes
No
Is your income likely to decline in the next two years?
Yes
No
Are you a co-maker, co-signer, or guarantor on any loan?
Yes
No
(If YES) For whom (name of the other obligated on the loan)
BY FILLING OUT THIS APPLICATION I (WE) AGREE TO THE FOLLOWING: I (we) certify that all statements on this application are true and complete for the purpose of obtaining credit. I (we) agree that Leadco Community Credit Union may obtain and use consumer credit reports and exchange credit and employment information in connection with this application. I (we) authorize any person, association, firm or corporation to furnish, on request of this Credit Union, information concerning me or my affairs. (Sec. 1014, Title 13, U.S. Code makes it a Federal Crime to knowingly make a false statement on this application to a Federally Insured Credit Union.) I (we) agree that this account will be subject to the terms and conditions of all applicable Lending Agreements and Disclosure Statements. I (we) agree that a photocopy or facsimile of this application shall be as binding as the original.
I/we have read and understand the above disclosure.
*
Yes
No
Submit
Should be Empty: