Secure Loan Application
1801 Superior Avenue, Cleveland, OH 44114
Phone: (216) 999-4270   •  Fax: (216) 999-3527
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.
By submitting this form I agree that 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.