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How can we contact you: (phone# and times available)
If you are applying for joint credit with another person, complete the applicant and joint applicant section.
Type of Loan Applied For:
HEAT Loan (Mass Save 0% Loan)
VISA® Credit Card, Option 1, 14.90%(w/cash back option)
VISA® Credit Card, Option 2, 9.90%(no cash back option)
Amount applied for $
Desired Length of Repayment (mos):
If applying for auto loan please supply the following:
Is your Income likely to decline in the next 2 years?
Have you ever filed bankruptcy or had a repossession?
Are you a cosigner on any other loan?
Are there any judgments or liens against you?
If a yes
answer is given to any of the above questions, please provide
an explanation below:
Bank holding mortgage on home:
Current year tax:
Original Mortgage Amount: $
Market Value: $
Purchase Price: $
Does your first mortgage have a variable interest rate?
List all persons named on the deed:
Savings account bank:
Savings balance $
Checking account bank:
Checking balance $
I do not wish to furnish this information
Hispanic or Latino,
Not Hispanic or Latino
American Indian or Alaska Native,
Black or African American,
Native Hawaiian or Other Pacific Islander,
IMPORTANT INFORMATION ABOUT PROCEDURES FOR OPENING A NEW ACCOUNT
Mills42 Federal Credit Union is protecting your identity, as required by the USA Patriot Act.
To help our government fight the financing of terrorism and money laundering
activities, Federal law requires all financial institutions to obtain,
verify, and record information that identifies each person who opens
What this means to you:
When you open an account, we will ask you for your name, date of birth,
current home address and Social Security Number or Taxpayer Identification
Number, and other information that will help us identify you. We will
also request a copy of a current photo ID, which clearly lists this
information and a utility bill from your current address, preferably
a phone bill.
In all cases, protection of our members’ identity and confidentiality
is our pledge to you.
Thank you for your understanding and for joining us in securing a safer
tomorrow for us all.