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 following:

Type of Loan Applied For:
Personal (Signature) Share Secured Unsecured Line of Credit New Car
Used Car Personal Property Motorcycles Classic Automobile Recreational Vehichle

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

Method of Payment:
Payroll Deduction Automatic Transfer from Shares Drafts


Applicant:

Name:
Account #:
Social Security #:
Birthdate (MM/DD/YY):
Home Phone #:
Present Address:
Street:
City:
State & Zip:
Current Address since: (MM/YY)
If less than 3 yrs enter previous address:


Joint Applicant:

Name:
Account #:
Social Security #:
Birthdate (MM/DD/YY):
Home Phone #:
Present Address:
Street:
City:
State & Zip:
Current Address since: (MM/YY)
If less than 3 yrs enter previous address:


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.
Employer Name:

Employer Phone #:
Employer Address:

Position:
Date Hired (MM/DD/YY):
Monthly Gross Income: $
Other Income: $ per Month
Employer Name:

Employer Phone #:
Employer Address:

Position:
Date Hired (MM/DD/YY):
Monthly Gross Income: $
Other Income: $ per Month

Complete if current is less than 2 years:
Previous Employers Name:

Years Employed:

Complete if current is less than 2 years:
Previous Employers Name:

Years Employed:


Credit Information
Please list all open Accounts with a balance.
Creditor Monthly
Payment
Housing
Rent Own None
Creditor Monthly
Payment
Housing
Rent Own None

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 Request” 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.


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