sscu Home Page

Secure Loan Application Form

1807 Lincoln Way East, Massillon, OH 44646
Phone: 330-833-0751 | Fax: 330-833-2159

   
Loan Information

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 the 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.

You must be a Superior Savings Credit Union member to apply for a loan:
Check below to indicate the type of account(s) and type of credit for which you are applying. Married Applicants may apply for a separate account.

Are you applying for individual or joint credit ?: Individual    Joint

Type of Loan applying for:

New Auto       Used Auto       Motorcycle      
Personal Loan       Savings Secured       VISA Credit Card - Classic

Amount Requested: $ .00
Repayment term:
Desired Payment schedule:
If required will you provide collateral to secure this loan?
  If yes please describe collateral:
(ie., yr, make, model)
  What is the value of the collateral? $ .00
Method of Payment:


Payment Protection Coverage
Check coverage(s) desired. The Credit Union will disclose the cost of this voluntary insurance to you. A separate enrollment form which discloses the terms and conditions must be signed for coverage to become effective.
Would you like to purchase Credit Life Insurance?
Single Credit Life (Only Available for Applicant ; approximately 5.2¢ per $100.00 per month)
Joint Credit Life (Approximately 9.1¢ per $100.00 per month)
None

Would you like to purchase Single Credit Disability Insurance? (Ranges From .1390 To .4986 Per $100.00 Per Month)
Yes (Primary Member Only)
None


Applicant Information
Applicant's Name:
Driver License #:
Social Security #:
Email:
US Citizen: Yes No
Birthdate (MM/DD/YYYY):
Home Phone #:
Cell Phone #:
Street Address:
City: State:
Zip #:
Current Address since: (MM/YY)
If less than 3 yrs enter previous address:
Joint Applicant's Name:
Joint Applicant Type:
Driver License #:
Social Security #:
Email:
US Citizen: Yes No
Birthdate(MM/DD/YYYY):
Home Phone #:
Cell Phone #:
Street Address:
City: State:
Zip #:
Current Address since: (MM/YY)
If less than 3 yrs enter previous address:


Employment Information
Applicant Employer's Name:
Title or Position:
Employer Phone #:
Are you self employed?
Type of Business
Date Hired (MM/DD/YY):
Monthly Gross Income ($):
Other Income ($): per Month
Complete if current employment is less than 2 years:
Previous Employers Name:
Yrs Employed:
Joint App. Employer's Name:
Title or Position:
Employer Phone #:
Are you self employed?
Type of Business
Date Hired (MM/DD/YY):
Monthly Gross Income ($):
Other Income ($): per Month
Complete if current employment is less than 2 years:
Previous Employers Name:
Yrs Employed:

NOTE: Alimony, child support, or separate maintenance income need not be revealed if You do not choose to have it considered as a basis for this credit request.


Debts & Assets
Lender
Type
Balance
Min. Pmt.
$ .00
$ .00
$ .00
$ .00
$ .00
$ .00
$ .00
$ .00
$ .00
$ .00
$ .00
$ .00
$ .00
$ .00
$ .00
$ .00
$ .00
$ .00
Child Support Payments / Alimony $
Assets:
Description: Value:
    
Description: Value:
    
Have you ever filed for bankruptcy or had debt adjustment under Chapter 13?
   Are you a party in a lawsuit?
   Have you ever had property foreclosed or repossesion in the last 7 years?
   Is your income likely to decline in the next two years?
Are you co-maker/endorser on any loan not listed above?
   If yes then for whom?
   If yes then to whom?


References (Nearest relative not living with you)
First Name: Middle Name: Last Name: Suffix:
   Home Phone Number:
   555-555-5555
   What is their home address?
Street: City: State: Zip:
   What is the relationship?


 
Contact Method
  How would you prefer to be contacted? Home Phone Cell Phone Email
 
  Additional Comments:


Submit Application

Identification Program As Required By The USA Patriot Act:
To help the government fight the funding of terrorism and money laundering activities, Federal law requires all financial institutions to obtain, verify, and record information that identifies each person who opens an account.

What This Means For You:
We will ask for your name, address, date of birth, and other information that will allow us to identify you. We may also ask to see your driver’s license or other identifying documents. In some cases, identification will be requested for current account holders if original documentation was not obtained with the opening of the account.

We ask for your understanding as we work to support these efforts to maintain the security of your funds and our country.

You agree that everything stated in this application is correct to the best of your knowledge. The Credit Union is authorized to investigate your creditworthiness, employment history, and to obtain a credit report and to answer questions about their credit experience with you. You understand that any false or misleading statement in your application may cause any loan or extension of credit to be in default. You authorize us to accept your facsimile signatures on this application and agree that your facsimile signature will have the same legal force and effect as your original signature. You assume any risk that may be associated with permitting us to accept your facsimile signature.

By pressing the "Submit Form" button below, you agree to the above statement. You understand that we may require your signature on additional documents prior to disbursing any credit proceeds.