Credit Application

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Application Information

* Loan Type Error:Loan Type

* Do you want to include a Co-Applicant: YesNo Error:Co-Applicant check

* Loan Sub Type Error:Loan Subtype

Applicant Information

* Email

* Social Security Number

* First Name * Last Name Middle Name

Suffix * Member Type

* Date of Birth (MM/DD/YYYY) * Marital Status # Of Dependents

Address Information

Current Address

* Street Address

* City * State * Zip Code

* Housing Type * Monthly Payment

$ Creditor

* Time at Current Residence (years) (months) * Home Phone Mobile Phone

Previous Address

* Street Address

* City * State * Zip Code

* Time at Previous Residence (years) (months)

Loan Information

* New/Used

* Year of Vehicle

* Requested Amount:$

* Requested Term

Employment Information

* Employment Status

* Are you an Employee of this Credit Union?

Yes

Current Employer

* Employer * Position

* Gross Income

$ * Frequency

* Work Phone Extension

* Time at Current Employer (years) (months)

* Source * Gross Income

$ * Frequency

Previous Employer

* Employer * Position

* Time at Previous Employer (years) (months)

Other Income

Applicant has other income

* Source of Income

* Amount

$ * Frequency

Co-Applicant Information

Co-Applicant has authorized applicant to apply for joint credit *

* Member Type * Relationship to Applicant Help

* Detailed Relationship

* First Name Middle Name

* Last Name Suffix

* Social Security Number

* Email Address

* Date of Birth (MM/DD/YYYY)

* Marital Status # Of Dependants

Co-Applicant Address Information

Current Address

Current address same as applicant

* Street Address

* City * State * Zip Code

* Housing Type * Monthly Payment

$ Creditor

* Time at Current Residence (years) (months) * Home Phone Mobile Phone

Previous Address

* Street Address

* City * State * Zip Code

*Time at Previous Residence

(years) (months)

Co-Applicant Employment Information

* Employment Status

* Are you an Employee of this Credit Union?

Yes

Current Employer

* Employer * Position

* Gross Income

$ * Frequency

* Work Phone Extension

* Time at Current Employer (years) (months)

* Source * Gross Income

$ * Frequency

Previous Employer

* Employer * Position

* Time at Previous Employer (years) (months)

Co-Applicant Other Income

Co-Applicant has other income

* Source of Income

* Amount

$ * Frequency