Loanliner 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: Each applicant must individually complete appropriate section below. If Co-Borrower is spouse of the applicant, mark the Co-Applicant box.
Guarantor: Complete the Other section if you are a guarantor on an account/loan.


Check below to indicate the type of credit for which you are applying. Married Applicants may apply for a separate account.

LOANLINER Account/Loan: Individual Joint
(Including ATM/Debit Card Access to the Account if Available)
Credit Limit Requested: $
Purpose/Collateral:
Repayment: Payroll Deduction Cash Military Allotment Automatic Payment

PAYMENT PROTECTION

Are you interested in having your loan protected? Yes No
If you answer "yes", then the credit union will disclose the cost of this voluntary payment protection to you. A separate election which discloses the terms and conditions must be signed for protection to be effective.

APPLICANT

Name

Password

Account Number

Social Security number

Driver's License # / State

Age of Dependents:

Email:

Birth Date (01/31/1970)

,

Home Phone

Bus. Phone

Cell Phone

Present Address (Street, City, State, Zip)

Own Rent
Length At Residence

Previous Address (Street, City, State, Zip)

Own Rent
Length At Residence

Complete for joint credit, secured credit or if you live in a community
property state:

Married
Separated
Unmarried (Single - Divorce - Widowed)

EMPLOYMENT/INCOME

Employer Name & Address (Street, City, State, Zip)

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

$ Per

Net Gross

Other Income

$ Per

Source:

MILITARY: Is duty station transfer expected during next year?
Yes No
Where Ending/Separation Date


Previous Employer Name & Address (If employed less than 5 years)

Start Date

End Date

REFERENCE

Name and Address of nearest relative not living with you

Relationship

Home Phone

OTHER: Co-Applicant Spouse Guarantor

Name

Password

Account Number

Social Security number

Driver's License # / State

Age of Dependents:

Email:

Birth Date (01/31/1970)

,

Home Phone

Bus. Phone

Cell Phone

Present Address (Street, City, State, Zip)

Own Rent
Length At Residence

Previous Address (Street, City, State, Zip)

Own Rent
Length At Residence

Complete for joint credit, secured credit or if you live in a community
property state:

Married
Separated
Unmarried (Single - Divorce - Widowed)

EMPLOYMENT/INCOME

Employer Name & Address (Street, City, State, Zip)

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

$ Per

Net Gross

Other Income

$ Per

Source:

MILITARY: Is duty station transfer expected during next year?
Yes No
Where Ending/Separation Date


Previous Employer Name & Address (If employed less than 5 years)

Start Date

End Date

REFERENCE

Name and Address of nearest relative not living with you

Relationship

Home Phone

WHAT YOU OWE

What You Owe Creditor Name (other than this credit union) Interest Rate Balance Monthly Payment Owed By
Applicant Other
% $ $
% $ $
% $ $
% $ $
% $ $
% $ $
% $ $
% $ $
% $ $
% $ $
List any names under which your credit references and credit history can be checked:

WHAT YOU OWN

What You Own List location of property or financial institution Market Value Pledged as collateral for another loan Owned By
Applicant Other
$ Yes No
$ Yes No
$ Yes No
$ Yes No
$ Yes No
$ Yes No
$ Yes No
$ Yes No
$ Yes No
$ Yes No

OTHER INFORMATION ABOUT YOU

If you answer "yes" to any question other than #1, explain below in provided area Applicant Other
1. Are you a U.S. Citizen or Permanent Resident Alien? Yes No Yes No
2. Do you currently have any outstanding judgments or have you ever filed for bankruptcy, had a debt adjustment plan confirmed under chapter 13, had property foreclosed upon or repossessed in the last 7 years, or been a party in a lawsuit? Yes No Yes No
3. Is your income likely to decline in the next two years? Yes No Yes No
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):
Yes No Yes No
Explain

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 766.59, or court decree under Section 766.70 will adversely affect the rights of the Credit Union unless the Credit Union is 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 check 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.
Wisconsin Residents Only

SIGNATURES

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 us in writing immediately. You authorize the Credit Union to obtain credit reports in connection with this application for credit and for any update, increase, renewal, extension, or collection 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.
APPLICANT - I agree to Terms and Conditions
CO-APPLICANT - I agree to Terms and Conditions

CREDIT UNION USE ONLY


Date

__________
___ Approved

___ Declined
Approved Limits:
Signature

$_________
Line of Credit

$_________
Other

$_________
Other

$_________
Debt/Ratio Score Before After

_____________________

Loan Officer Comments: _______________________________________________

Signature: _______________ Date: ________