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ONLINE BANKING

Loan Application

Apply for a loan with ease below!

Married Applicants may apply for a separate account. Check the appropriate box to indicate Individual Credit or Joint Credit.

Individual Credit: Complete Applicant sections if only the applicant's income is considered for loan approval. Complete Applicant and Co-Applicant sections: (1) if you are relying on income from alimony, child support, or separate maintenance or on the income or assets of another person as the basis for repayment of credit requested, or; (2) if you reside in a Community Property State, or; (3) if you are relying on property located in a Community Property State as a basis for repayment of the credit requested. Community Property States include: AK, AZ, CA, ID, LA, NM, NV, TX, WA, and WI. Refer A Member Promotional Discount Disclosure: *APR = Annual Percentage Rate. Effective 12/1/2023. Limited time offer. We reserve the right to modify or conclude promotion at any time. Annual percentage rate, must qualify, must be or become a member, qualifying individuals will receive .5% off their qualified loan rate. Rates subject to change without notice. Other terms and rates available. Member NCUA, Joint Credit: Complete Applicant and Co-Applicant sections if your co-applicant will be contractually liable for repayment of the loan and sign below:

Individual Application

Joint Application

Amount requested

Purpose of Loan

Please choose ONE loan type

PRIMARY APPLICANT

Name

First Name

Last Name

Account number

Social Security Number

Birth date

YYYY

Phone

(###)

###

####

Current address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Date of Residency at Current Address

Please choose move in date for your current address

YYYY

Monthly housing expense

PRIMARY APPLICANT EMPLOYMENT

Employer name

Hire date

YYYY

Position

PRIMARY APPLICANT INCOME

Employment income

PER MONTH (GROSS)

Other income notice: Alimony, child support, or separate maintenance income need not be revealed if you do not choose to have it considered.)

Per Month (Gross)

Other income source

PRIMARY APPLICANT REFERENCES

Name and address of nearest relative not living with you

First Name

Last Name

Home phone

(###)

###

####

Relationship

CO-APPLICANT INFORMATION

PLEASE COMPLETE ONLY IF YOU ARE APPLYING FOR JOINT CREDIT, SECURED CREDIT, OR IF YOU LIVE IN A COMMUNITY PROPERTY STATE.

Spouse Applying Jointly

Separated Applying Jointly

Family Applying Jointly

Other Applying Jointly

Name

First Name

Last Name

Social Security Number

Birth date

YYYY

Home phone

(###)

###

####

Current address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Monthly housing expense

Relationship to Primary

CO-APPLICANT EMPLOYMENT

Employer name

Hire Date

YYYY

Position

CO-APPLICANT INCOME

Employment income (gross)

Per Month

Other income notice: Alimony, child support, or separate maintenance income need not be revealed if you do not choose to have it considered.)

Per month (gross)

Other income source

LOAN APPLICATION SIGNATURE(S)

PLEASE READ BEFORE SIGNING:

All the information in this application is true. I understand that section 1014 Title 18 U.S. Code makes it a federal crime to knowingly make a false statement on this application. You have my permission to check it. You may retain this application even if not approved. I understand that you may receive information from others about my credit and you may answer questions and requests from others seeking credit or experience information about me or my accounts with you. If this application is approved, I agree to honor the provisions of the credit or loan agreement and security agreement covering my account or loan. (If this application is for two of us, this statement applies to both of us.) Credit Report Authorization. By signing this Application, I authorize you to obtain my credit report for the purposes of evaluating this application and to obtain subsequent credit reports on an on-going basis in connection with this transaction, and for all other legitimate purposes, such as reviewing my accounts or taking collection action on the account. Permission to contact: By providing a wireless telephone number (i.e., cell phone), I consent to receiving calls, including autodialed and prerecorded message calls, from the credit union or its third party debt collector at that number. IMPORTANT NOTICE ABOUT PROCEDURES FOR OPENING A NEW ACCOUNT To help the government fight the funding of terrorism and money laundering activities, Federal law requires all financial institutions to obtain, verify, and record information that identifies each person who opens an account. What this means for me: When I open an account, you will ask for my name, address, date of birth, and other information that will allow you to identify me. You may also ask to see my driver's license or other identifying information.

Date

YYYY

Signature of Co-Applicant

Date

YYYY

HAVE YOU OMITTED ANYTHING? REMEMBER: INCOMPLETE APPLICATIONS CANNOT BE PROCESSED.