Community United Federal Credit Union


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Forms & Applications

LOAN APPLICATION

Individual Credit: You must complete the Applicant section about yourself and the Other section about your spouse if:

1.	you live in or the property pledged as collateral is located in a community property state (AK, AZ, CA, ID, LA, NM, NV, TX, WA, WI),
2.	your spouse will use the account, or
3.	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 Other section to the extent possible about the person on whose payments you are relying.

Joint Credit: If you are applying with another person, complete the Applicant and Other sections.
Guarantor: Complete the Other section if you are a guarantor on an account/loan.

Check below to indicate the type of account(s) and type of credit for which you are applying. Married applications may apply for a separate account

LOANLINER Account/Loan:

Individual

Joint

Amount Requested $____________

Purpose/Collateral:_____________________

(Including ATM/Debit Card access to the account if Available)

Repayment:

Payroll Deduction

Cash

Military Allotment

Automatic Payment

Other ______________

Payment Protection

Single Credit Disability Insurance

Single Credit Life Insurance

Joint Credit Life Insurance

Check coverage(s) desired. The credit union will disclose the cost of this voluntary insurance to you. A separate insurance election which discloses the terms and conditions must be signed for coverage to become effective.

Applicant

Other:

Co-Applicant

Spouse

NAME (last - first - Initial)

MOTHER'S MAIDEN NAME

ACCOUNT NUMBER

SOCIAL SECURITY NUMBER

DRIVER'S LICENSE NUMBER / STATE

LIST AGES OF DEPENDENTS NOT LISTED BY OTHER APPLICANT (Exclude Self)

BIRTH DATE	HOME PHONE	BUSINESS PHONE / EXT.
	( )	( )

E-MAIL ADDRESS

PRESENT ADDRESS (Street - City - State - Zip)

OWN

RENT

YEARS
AT THIS
ADDRESS

PREVIOUS ADDRESS (Street - City - State - Zip)

OWN

RENT

YEARS
AT THIS
ADDRESS

COMPLETE FOR JOINT CREDIT, SECURED CREDIT OR IF YOU LIVE IN A COMMUNITY PROPERTY STATE:

MARRIED

SEPARATED

UNMARRIED

(Single - Divorced - Widowed)

MORTGAGE/RENT OWED TO:

EMPLOYMENT/INCOME

NAME AND
ADDRESS OF
EMPLOYER

TITLE/GRADE

START DATE

HOURS AT WORK

SUPERVISOR'S NAME

IF SELF EMPLOYED, TYPE OF BUSINESS

NOTICE: :

ALIMONY CHILD SUPPORT, OR SEPARATE MAINTENANCE INCOME NEED NOT BE REVEALED IF YOU DO NOT CHOOSE TO HAVE IT CONSIDERED

EMPLOYMENT INCOME

OTHER INCOME

$_______________

PER_______________

$_______________

PER_______________

NET

GROSS

SOURCE______________________________

MILITARY: IS DUTY STATION TRANSFER EXPECTED DURING NEXT YEAR?

YES

WHERE

ENDING/SEPARATION DATE

PREVIOUS EMPLOYER NAME AND ADDRESS IF EMPLOYED LESS THAN FIVE YEARS

STARTING DATE
________________
ENDING DATE

Other

Co-Applicant

Spouse

Guarantor

NAME (last - first - Initial)

MOTHER'S MAIDEN NAME

ACCOUNT NUMBER

SOCIAL SECURITY NUMBER

DRIVER'S LICENSE NUMBER / STATE

LIST AGES OF DEPENDENTS NOT LISTED BY OTHER APPLICANT (Exclude Self)

BIRTH DATE	HOME PHONE	BUSINESS PHONE / EXT.
	( )	( )

E-MAIL ADDRESS

PRESENT ADDRESS (Street - City - State - Zip)

OWN

RENT

YEARS
AT THIS
ADDRESS

PREVIOUS ADDRESS (Street - City - State - Zip)

OWN

RENT

YEARS
AT THIS
ADDRESS

COMPLETE FOR JOINT CREDIT, SECURED CREDIT OR IF YOU LIVE IN A COMMUNITY PROPERTY STATE:

MARRIED

SEPARATED

UNMARRIED

(Single - Divorced - Widowed)

MORTGAGE/RENT OWED TO:

EMPLOYMENT/INCOME

NAME AND
ADDRESS OF
EMPLOYER

TITLE/GRADE

START DATE

HOURS AT WORK

SUPERVISOR'S NAME

IF SELF EMPLOYED, TYPE OF BUSINESS

NOTICE: :

ALIMONY CHILD SUPPORT, OR SEPARATE MAINTENANCE INCOME NEED NOT BE REVEALED IF YOU DO NOT CHOOSE TO HAVE IT CONSIDERED

EMPLOYMENT INCOME

OTHER INCOME

$_______________

PER_______________

$_______________

PER_______________

NET

GROSS

SOURCE______________________________

MILITARY: IS DUTY STATION TRANSFER EXPECTED DURING NEXT YEAR?

YES

WHERE

ENDING/SEPARATION DATE

PREVIOUS EMPLOYER NAME AND ADDRESS IF EMPLOYED LESS THAN FIVE YEARS

STARTING DATE
_________________
ENDING DATE

Applicant Reference

NAME AND ADDRESS
OF NEAREST
RELATIVE NOT
LIVING WITH YOU

RELATIONSHIP

_______________
HOME PHONE

Other Reference

NAME AND ADDRESS
OF NEAREST
RELATIVE NOT
LIVING WITH YOU

RELATIONSHIP

_______________
HOME PHONE

What You Owe	CREDITOR NAME OTHER THAN THIS CREDIT UNION (Attach additional sheet(s) if necessary)	INTEREST RATE	PRESENT BALANCE	MONTHLY PAYMENT	OWED BY
What You Owe		INTEREST RATE	PRESENT BALANCE	MONTHLY PAYMENT	Applicant	Other
__Rent__1st Mortgage (Include Tax & Ins.)			$	$
2nd Mortgages			$	$
1st Auto Loan			$	$
2nd Auto Lone			$	$
Child-Care			$	$
Child Support			$	$
Credit Card			$	$
Credit Card			$	$
Other			$	$
Other			$	$
List any names under which your credit references and credit history can be checked:		TOTALS	$	$

What You Owe	LIST LOCATION OF PROPERTY OR FINANCIAL INSTITUTION	MARKET VALUE	PLEDGED AS COLLATERAL FOR ANOTHER LOAN			OWED BY
What You Owe	LIST LOCATION OF PROPERTY OR FINANCIAL INSTITUTION	MARKET VALUE	PLEDGED AS COLLATERAL FOR ANOTHER LOAN			Applicant	Other
HOME		$		YES	NO
AUTO		$		YES	NO
SAVINGS		$		YES	NO
CHECKING		$		YES	NO
OTHER (DESCRIBE)		$		YES	NO

Other Information About You	IF YOU ANSWER "YES" TO ANY QUESTION OTHER THAN #1, EXPLAIN ON AN ATTACHED SHEET	APPLICANT		OTHER
Other Information About You		YES	NO	YES	NO
1. ARE YOU A U.S. CITIZEN OR PERMANENT RESIDENT ALIEN?
2. DO YOU CURRENTLY HAVE ANY OUTSTANDING JUDGMENTS OR HAVE YOU EVER FILED FOR BANKRUPTCY, HAD A DEBT ADJUSTMENT PLAN COFIRMED UNDER CHAPTER 13, HAD PROPERTY FORECLOSED UPON OR REPOSSESSED IN THE LAST 7 YEARS, OR BEEN A PARTY IN A LAWSUIT?
3. IS YOUR INCOME LIKELY TO DICLINE IN THE NEXT TWO YEARS?
4. ARE YOU A CO-MAKER, CO-SIGNER OR GUARANTOR ON ANY LOAN NOT LISTED ABOVE? FOR WHOM? (Name of others obligated on loan): TO WHOM? (Name of creditor):

STATE LAW NOTICES

OHIO RESIDENTS ONLY: The Ohio laws against discrimination require that all creditors make credit equally available to all creditworthy customers, and that credit reporting agencies maintain separate credit histories on each individual upon request. The Ohio Civil Rights Commission administers compliance with this law.

WISCONSIN RESIDENTS ONLY:(1) No provision of any marital property agreement, unilateral statement under Section 766.70, or court decree under 766.70 will adversely affect the rights of the Credit Union unless the Credit Unions furnished a copy of the agreement, statement or decree, or has actual knowledge of its terms, before the credit is granted or the account is opened. (2) Please sign if you are not applying for this account or loan with your spouse. The credit being applied for, if granted, will be incurred in the interest of the marriage or family of the undersigned.

X_______________________________________________________________________________
SIGNATURE FOR WISCONSIN RESIDENTS ONLY Date

Signatures

1. You promise that everything you have stated in this application is correct to the best of your knowledge. If there are any important changes you will notify use in writing immediately. You authorize the Credit Union to obtain credit reports in connection with this application for credit and any update, increase, renewal or extension of the credit received. You understand that the Credit Union will rely on the information in this application and your credit report to make its decision. 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. 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.