Secure Loan Application Exit to Loan Page 
 
SECURE LOAN APPLICATION
501 W. Merriman
Sinton, TX  78387

Married applicants may apply for a separate account. If you are applying for Individual Credit, you must complete the Applicant section about yourself and the Co-Applicant section about your spouse if:
  1. Your spouse will use the account, or
  2. You are relying on your spouse's income as a basis for repayment.
If you are relying on income from alimony, child support or separate maintenance, complete the Co-Applicant section to the extent possible about the person on whose payments you are relying.If you are applying for Joint Credit with another person, complete the Applicant and Co-Applicant sections.
TYPE AND AMOUNT OF CREDIT YOU'RE REQUESTING
Amount/Credit Limit Requested: $
Approximate Time to Repay: How Many? Periods:
Loan Type:
Loan Purpose:
Type of Credit: Individual Joint
Your Email Address:

PAYMENT PROTECTION COVERAGE
Check if desired
Check coverage(s) desired. We will disclose the cost of this Payment Protection Insurance - Credit Disability and Credit Life - to you. A separate enrollment form which discloses the terms and conditions must be signed for coverage to become effective.
Yes
No
Do you want your loan protected for you and your family if you become disabled?

Applicant   Co-Applicant
Name:
Email:
Name:
 
CU Account #: CU Account #:
Social Security #: Social Security #:
Please indicate your marital status 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):
Married Separated Unmarried (Single - Divorced - Widowed)
Please indicate your marital status 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):
Married Separated Unmarried (Single - Divorced - Widowed)
Driver's License #: State:   Driver's License #: State:
Birth Date: Birth Date:
Home Phone:
Business Phone:
Home Phone:
Business Phone:
Present Address:



Years There: Own Rent
Present Address:



Years There: Own Rent
DEBTS DEBTS
Mortgage/Rent owed to:   Mortgage/Rent owed to:
Balance (Mortgage only): Balance (Mortgage only):
Monthly Payment:
Current APR % (Mortgage only):
Monthly Payment:
Current APR % (Mortgage only):
Person Responsible for Payment: Person Responsible for Payment:
Employment and Income: In order to expedite the processing of your loan application please fax your paystub copies to (361) 364-2132, Attention: Loan Department. If self-employed or retired, financial statement or income tax returns will be needed.
Employment and Income: In order to expedite the processing of your loan application please fax your paystub copies to (361) 364-2132, Attention: Loan Department. If self-employed or retired, financial statement or income tax returns will be needed.
INCOME INCOME

Employer:

Hire Date: mm/dd/yy

 

Employer:

Hire Date: mm/dd/yy

Income: $ Net Gross
Annual Monthly
Bi-weekly Weekly
 
Income: $ Net Gross
Annual Monthly
Bi-weekly Weekly
 

Other Income: (Notice: Alimony, child support or separate maintenance income need not be revealed if you do not have it considered as a basis for repaying this obligation.)
Source:
$
Annual
Monthly
Hourly

Other Income: (Notice: Alimony, child support or separate maintenance income need not be revealed if you do not have it considered as a basis for repaying this obligation.)
Source:
$
Annual
Monthly
Hourly

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 will require your signature on additional documents prior to disbursing any credit proceeds.