Secure Loan Advance Request

Online loan applications submitted, approved, and booked within 30 days of receipt
will receive a .25% discount off the posted interest rate.
Contact us for details.
*Discount excludes variable rate loans & lines of credit.

Please Enter your Email Address:

If you are applying for joint credit, secured credit or if you live in a community property state (AZ,CA,ID,LA,NM,NV,TX,WA,WI,Puerto Rico), please complete the information for both the applicant and joint applicant or jointly secured parties.

Type of Loan Advance Requested:
Personal (Signature) Share Secured Unsecured Line of Credit
New Car Used Car Other:

Amount applied for: $
Purpose:
Desired Length of Repayment (months):

Method of Payment: Payroll Deduction Automatic Transfer from Savings Checking

I currently have Credit Disability Insurance Protection under my lending Plan ? Yes No

Primary Borrower: Name: Account #: Home Phone #: Has your address changed? Yes No If yes, please provide current address information.: Street: City: State & Zip: Current Address since: (MM/YY)	Co-Borrower: Name: Account #: Home Phone #: Has your address changed? Yes No If yes, please provide current address information.: Street: City: State & Zip: Current Address since: (MM/YY)
Has your employment status changed? Yes No If yes, please provide current employer information. Employer Name: Employer Phone #: Employer Address: Position: Date Hired or Years Since Retirement (MM/DD/YY): Has your income changed? Yes No If yes, please provide current income information below Monthly Gross Income: $ Other Income: $ per Month	Has your employment status changed? Yes No If yes, please provide current employer information. Employer Name: Employer Phone #: Employer Address: Position: Date Hired or Years Since Retirement (MM/DD/YY): Has your income changed? Yes No If yes, please provide current income information below Monthly Gross Income: $ Other Income: $ per Month
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.

Additional information the credit union may need to process your request:

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 "Send Application" 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.