Co-applicant Information * indicates required field First Name*  Last Name*  Account Number Social Security Number*   (ex: 123456789) Date of Birth* (mm/dd/yyyy) Home Phone* (ex: 4085313000) Bussiness Phone  (ex: 4085313000)  Ext.   Address* Street #       Street name            Type     Unit         City*   State*    Zip code*   Rent or Own* select... Rent Own   Years at this address*   years Previous Address (If less than 2 years at current address) Previous City   State    Zip code   Marital Status* select... Married Separated Single  (Complete for joint credit, secured credit or if you live in a community property state)   Employment Information Name of Employer* Employer Address* City, State, Zip* Your Title/Grade* Date of Hire* (mm/dd/yyyy)  Hours at Work   If self employed  ,Type of Business  Previous Employer Name Previous Employer Address (Street, City, State, Zip Start Date (mm/dd/yyyy)  End Date    Income Information Notice: Alimony, child support or separate maintenance income need not be revealed if you do not choose to have it considered. Gross Monthly Income from employment*   Other Monthly Income    Source       Other Monthly Income    Source     References Nearest Relative not living with you   Relationship   Relative's Address Phone Number (ex: 4085313000)   Debts In addition to Rent/Mortgage list all other debts (for example, auto loans, credit cards, second mortgage, home assoc. dues, alimony , child support, child care, medical, utilities, auto insurance, IRS liabilities, etc.) Please use a separate line for each credit card and auto loan. Type (Rent/Mortgage)   Creditor Name & Address   Account #   Original Balance   Present Balance   Monthly Payment Past Due       $   $   $         $   $   $         $   $   $         $   $   $         $   $   $         $   $   $         $   $   $         $   $   $         $   $   $         $   $   $     Financial Information If a "Yes" answer is given to a question, explain below * Do you have any outstanding judgments?  select... Yes No * Have you ever filed bankruptcy or had debt adjustment plan confirmed under chapter 13?  select... Yes No * Have you had property forclosed upon or given a deed in lieu of foreclosure in the last 7 years?  select... Yes No * Are you a party in a lawsuit?  select... Yes No * Are you other than a U.S citizen or permanent resident alien?  select... Yes No * Is your income likely to decline in the next two years?  select... Yes No * Are you a co-maker or co-signer or guarantor on any loan not listed above?  select... Yes No   You 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 understand that it is a crime to willfully and deliberately provide incomplete or incorrect information in this application. 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. NMLSR ID NUMBER: 458544   Information For Government Monitoring Purposes The following information is requested by the Federal Government for certain types of loans related to a dwelling, in order to monitor the lender's compliance with equal credit opportunity, fair housing and home mortgage disclosure laws. You are not required to furnish this information, but are encouraged to do so. The law provides that a Lender may discriminate neither on the basis of this information, nor on whether you choose to furnish it. If you furnish the information, please provide both ethnicity and race. For race, you may check more than one designation. If you do not furnish ethnicity, race, or sex, under Federal regulations, this lender is required to note the information on the basis of visual observation or surname. If you do not wish to furnish the information, please check the box below. (Lender must review the above material to assure that the disclosures satisfy all requirements to wich the lender is subject under applicable state law for the particular type of loan applied for.)     I do not wish to furnish this information.   Ethnicity:   Hispanic or Latino   Not Hispanic or Latino   Race:   American Indian or Alaska Native   Asian   Black or African American   Native Hawaiian or Other Pacific Islander   White   Sex:   Female   Male