Secure Loan Application

Loan Type

Loan Purpose

Requested Amount ($)

Applicant Information

First Name

Last Name

Member #

Social Security #

Date of Birth

Email Address

Phone Number

Street Address

City

State

Zip Code

Years at This Address

Driver's License

Housing Status

Monthly Housing Expense

Employment Information

Present Employer

Occupation

Employer Phone #

Employment Start Date

Gross Monthly Income for the Employer Above

Whole Dollars. If you would like us to include other sources of income, please discuss this with our Loan Officers. Alimony, child support, or separate maintenance income need not be revealed if you do not choose to have it considered as a basis for repaying this obligation.

Personal References

Please provide two references.

First and Last Name

Relationship To You

Phone #

First and Last Name

Relationship To You

Phone #

Is there a joint applicant?

No Yes

Joint Applicant Information

First Name

Last Name

Member Number #

Social Security #

Date of Birth

Email Address

Phone Number

Street Address

City

State

Zip Code

Years at This Address

Driver's License

Housing Status

Monthly Housing Expense

Joint – Employment Information

Present Employer

Occupation

Employer Phone #

Employment Start Date

Gross Monthly Income for the Employer Above

Joint – Personal References

Please provide two references.

First and Last Name

Relationship To You

Phone #

First and Last Name

Relationship To You

Phone #

Comments

Enter Comments Here

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.

Section 1014, Title 13, US Code makes it a federal crime to knowingly make a false statement on this application. I hereby agree that the information given is true, accurate and complete as of the date of this application submission

I have read this section and agree to the terms.

Loan Application

Applicant Information

Employment Information

Personal References

Please provide two references.

Joint Applicant Information

Joint – Employment Information

Joint – Personal References

Please provide two references.

Comments

Rails West Federal Credit Union Application and Solicitation Disclosure for VISA Platinum and VISA Secured

Rails West Federal Credit Union
Application and Solicitation Disclosure
for VISA Platinum and VISA Secured