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Loan Request

Please complete the application and review the authorization statement. To submit this form electronically, please fill out the form and then click on "Request Loan" at the bottom of the page. If you prefer, you may print and then either fax or mail the request. Please either submit electronically OR print and return; not both. Thank you.

Married applicants may apply for a separate account. If you are applying for Individual Credit, you must complete the Applicant section about yourself and the Co-Applicant section about your spouse if:

  1. Your spouse will use the account, or
  2. You are relying on your spouse's income as a basis for repayment.

If you are relying on income from alimony, child support or separate maintenance, complete the Co-Applicant section to the extent possible about the person on whose payments you are relying.

If you are applying for Joint Credit with another person, complete the Applicant and Co-Applicant sections.

Reminder: Fields marked with asterisks (*) on the secure form are required fields. The form will not be accepted without them.

Type and Amount of Credit You're Requesting

Is this your first loan from us? Yes   No
*Amount/Credit Limit Requested:
Purpose for Loan:
*Affordable Payment Amount:
*Loan Type:
Security Offered:
(for secured credit only, not applicable to credit cards)
*Type of Credit: Individual   Joint
Current Classic VISA, Platinum VISA and Secured Classic Plus VISA Credit Card Disclosures or Business VISA Credit Card Disclosure information.

Tell Us About Yourself

Applicant

*Name:

*Email:

CFCU Account #:

*Social Security #:

*Choose or Enter Your Password:

Please indicate your marital status if you are applying for Joint Credit, secured credit or if you live in a community property state:

Married
Separated
Unmarried (Single/Divorced/Widowed)

*Birth Date:

*Home Phone:

Cell Phone:

*Present Address:

*City:

*State:

*Zip:

How long have you lived at this address?

years   months

Own   Rent

Co-Applicant

*Name:

*Email:

CFCU Account #:

*Social Security #:

*Choose or Enter Your Password:

Please indicate your marital status if you are applying for Joint Credit, secured credit or if you live in a community property state:

Married
Separated
Unmarried (Single/Divorced/Widowed)

*Birth Date:

*Home Phone:

Cell Phone:

*Present Address:

*City:

*State:

*Zip:

How long have you lived at this address?

years   months

Own   Rent

Debts

*Mortgage/Rent owed to:

Balance (Mortgage only):

*Monthly Payment:

Debts — Co-Applicant

*Mortgage/Rent owed to:

Balance (Mortgage only):

*Monthly Payment:

Income

*Employer:

*Job Title:

*Income:

Net   Gross
Annual
Monthly
Bi-weekly
Weekly

*Business Phone:

Ext:

*Hire Date:

Other Income: (Notice: Alimony, child support or separate maintenance income need not be revealed if you do not have it considered as a basis for repaying this obligation.)

Source:

Amount:

Annual
Monthly
Hourly

Income — Co-Applicant

*Employer:

*Job Title:

*Income:

Net   Gross
Annual
Monthly
Bi-weekly
Weekly

*Business Phone:

Ext:

*Hire Date:

Other Income: (Notice: Alimony, child support or separate maintenance income need not be revealed if you do not have it considered as a basis for repaying this obligation.)

Source:

Amount:

Annual
Monthly
Hourly

References

Nearest relative not living with you —

*Name:

Address:

City, State, Zip:

*Phone:

References — Co-Applicant

Nearest relative not living with you —

*Name:

Address:

City, State, Zip:

*Phone:
*Are you a US citizen or permanent resident alien?  Yes    No
*Do you have any outstanding judgments?  Yes    No
*Have you ever filed for bankruptcy or had a debt adjustment plan configured under chapter 13?  Yes    No
*Have you had property foreclosed upon or repossessed in the last 7 years?  Yes    No
*Are you a party in a lawsuit?  Yes    No

Additional Comments:

By submitting this loan request, you agree that, if there are any important changes, you will notify us in writing immediately. You also agree to notify us of any change in your name, address or employment within a reasonable time thereafter.

You also promise that everything you have stated in this application is correct to the best of your knowledge and that the above information is a complete listing of all your debts and obligations. You authorize the credit union to obtain credit reports in connection with this application for credit and for any update, renewal or extension of the credit received. If you request, the credit union will tell you the name and address of any credit bureau from which it received a credit report on you. You also understand that it is a federal crime to willfully and deliberately provide incomplete or incorrect information on loan applications made to Federal Credit Unions or State Chartered Credit Unions insured by NCUA.

*This information must be completed

  
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