Secure Loan Application

Boise Office
333 N. 13th Street, Boise, ID 83701
Phone: (208) 388-2959  •  Fax: (208) 345-8885
Meridian Office
3103 St Lukes St., Meridian, ID 83642
Phone: (208) 388-2138  •  Fax: (208) 388-6930
Credit Union Member Number
Married Separated Unmarried (Including Single, Divorced, Widowed)
Complete this item if you live in a community property state (AZ, CA, ID, LA, NM, TX & WA).
Loan Amount Applying For Purpose Of Loan
$.00
GENERAL
Applicants Name Date Of Birth Age
Yrs
Street Address How Long
City, State, Zip
Home Phone # Cell Phone # Pager #
Social Security # Drivers License #
GENERAL
Co-Applicants Name Date Of Birth Age
Yrs
Street Address How Long
City, State, Zip
Home Phone # Cell Phone # Pager #
Social Security # Drivers License #
EMPLOYMENT
Present Employer Date Of Hire
Address (Street, City, State, Zip)
Job Title Work Phone # Ext #
Former Employer Number Of Years
 
EMPLOYMENT
Present Employer Date Of Hire
Address (Street, City, State, Zip)
Job Title Work Phone # Ext #
Former Employer Number Of Years
INCOME
Applicants Monthly Gross Income $.00
Income Notice: You can include all sources. You are not required to disclose alimony, child support, or separate maintenance income if you don't wish to have it considered as a basis for repaying this obligation.
 
INCOME
Applicants Monthly Gross Income $.00
Income Notice: You can include all sources. You are not required to disclose alimony, child support, or separate maintenance income if you don't wish to have it considered as a basis for repaying this obligation.
DEBTS
Mortgage/Rent $.00
Total Other Debts $.00
 
DEBTS
Mortgage/Rent $.00
Total Other Debts $.00
REFERENCES
Nearest Relative Relationship
City & State Phone #
Other Relative Relationship
City & State Phone #
Personal Reference Phone #
 
REFERENCES
Nearest Relative Relationship
City & State Phone #
Other Relative Relationship
City & State Phone #
Personal Reference Phone #
Have you been the subject of an order for relief under the federal bankruptcy or adjudicated a bankruptcy under the bankruptcy act in the past 10 years? Yes No
Everything that I have stated in this application is correct to the best of my knowledge. You are authorized to check my credit and employment history and to answer questions about your credit experience with me, there will be a $20 credit report fee.