Partiot CU Home Page

Secure Loan Application Form

4343 Telegraph St. Louis, MO 63129
Phone: (314) 892-6325

   
Type Of Loan Applying For

Type:

Amount Requested: $ .00       Purpose: Desired Length of Term: Months

Repayment: Shares Drafts



Applicant Information
Applicant's Name:
Account #:
Social Security #:
Email:
US Citizen: Yes No
Birthdate:
Home Phone #:
Cell Phone #:
Street Address:
City: State:
Zip #:
Current Address since: (MM/YY)
If less than 3 yrs enter previous address:
Joint Applicant's Name:
Account #:
Social Security #:
Email:
US Citizen: Yes No
Birthdate:
Home Phone #:
Cell Phone #:
Street Address:
City: State:
Zip #:
Current Address since: (MM/YY)
If less than 3 yrs enter previous address:


Employment Information
Applicant Employer's Name:
Employer Phone #:
Employer Address:
Position:
Date Hired (MM/DD/YY):
Monthly Gross Income ($):
Other Income ($): per Month
Complete if current employment is less than 2 years:
Previous Employers Name:
Yrs Employed:
Joint App. Employer's Name:
Employer Phone #:
Employer Address:
Position:
Date Hired (MM/DD/YY):
Monthly Gross Income ($):
Other Income ($): per Month
Complete if current employment is less than 2 years:
Previous Employers Name:
Yrs Employed:

Employment and Income: In order to expedite the processing of your loan application please fax your paystub copies to (314) 892-3580, Attention: Loan Department. If self-employed or retired, financial statement or income tax returns will be needed.

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.


Debts & Assets

Please list all open Accounts with a balance.


Creditor Monthly Payment
Housing
Rent Own None
Creditor Monthly Payment
Housing
Rent Own None


Submit Application

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 “Submit Form” 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.


Equal Housing Lender