Locoga Federal Credit Union
1592 Norman Drive
Valdosta, GA 31601
Fax: (229) 244-5995
LOAN APPLICATION
Individual Credit: You must complete the Applicant section about yourself and the Other section about your spouse if:
1. you live in or the property pledged as collateral is located in a community property state (AK, AZ, CA, ID, LA, NM, NV, TX, WA, WI),
2. your spouse will use the account, or
3. 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 Other section to the extent possible about the person on whose payments you are relying.
Joint Credit: If you are applying with another person, complete the Applicant and Other sections.
Guarantor: Complete the Other section if you are a guarantor on an account/loan.
Check below to indicate the type of account(s) and type of credit for which you are applying. Married applications may apply for a separate account
   
LOANLINER Account/Loan:    
   
Individual  
   
Joint    Amount Requested $:___________________  
Purpose/Collateral:_______________________________________________________________________________________  
Repayment:
   
Payroll Deduction 
   
Cash  
   
Military Allotment 
   
Automatic Payment 
   
Other ______________
Payment Protection
   
Single Credit Disability Insurance 
   
Single Credit Life Insurance 
   
Joint Credit Life Insurance 
Check coverage(s) desired. The credit union will disclose the cost of this voluntary insurance to you. A separate insurance election which discloses the terms and conditions must be signed for coverage to become effective.
Applicant
 NAME (last - first - Initial)  MOTHER'S MAIDEN NAME
 ACCOUNT NUMBER  SOCIAL SECURITY NUMBER
 DRIVER'S LICENSE NUMBER / STATE  LIST AGES OF DEPENDENTS (Exclude Self)    
BIRTH DATE HOME PHONE BUSINESS PHONE / EXT. CELL PHONE.
  (     ) (     ) (     )
E-MAIL ADDRESS
PRESENT ADDRESS (Street - City - State - Zip)
   
OWN  
   
RENT  
 
YEARS
AT THIS
ADDRESS 
PREVIOUS ADDRESS (Street - City - State - Zip)
   
OWN  
   
RENT  
 
YEARS
AT THIS
ADDRESS 
COMPLETE FOR JOINT CREDIT, SECURED CREDIT OR IF YOU LIVE IN A COMMUNITY PROPERTY STATE:
   
MARRIED
   
SEPARATED
   
UNMARRIED (Single - Divorced - Widowed)
MORTGAGE/RENT OWED TO:
      EMPLOYMENT/INCOME     
NAME AND
ADDRESS OF
EMPLOYER
TITLE/GRADE START DATE HOURS AT WORK
SUPERVISOR'S NAME IF SELF EMPLOYED, TYPE OF BUSINESS
NOTICE:  : ALIMONY CHILD SUPPORT, OR SEPARATE MAINTENANCE INCOME NEED NOT BE REVEALED IF YOU DO NOT CHOOSE TO HAVE IT CONSIDERED
EMPLOYMENT INCOME OTHER INCOME
$_______________ PER_______________ $_______________ PER_______________
   
NET
   
GROSS
  SOURCE______________________________
MILITARY: IS DUTY STATION TRANSFER EXPECTED DURING NEXT YEAR?
   
YES 
   
NO 
WHERE ENDING/SEPARATION DATE
PREVIOUS EMPLOYER NAME AND ADDRESS IF EMPLOYED LESS THAN FIVE YEARS

STARTING DATE
________________
ENDING DATE


Other
   
 Co-Applicant
   
 Spouse
   
 Guarantor
 NAME (last - first - Initial)  MOTHER'S MAIDEN NAME
 ACCOUNT NUMBER  SOCIAL SECURITY NUMBER
 DRIVER'S LICENSE NUMBER / STATE  LIST AGES OF DEPENDENTS (Exclude Self)    
BIRTH DATE HOME PHONE BUSINESS PHONE / EXT. CELL PHONE.
  (     ) (     ) (     )
E-MAIL ADDRESS
PRESENT ADDRESS (Street - City - State - Zip)
   
OWN  
   
RENT  
 
YEARS
AT THIS
ADDRESS 
PREVIOUS ADDRESS (Street - City - State - Zip)
   
OWN  
   
RENT  
 
YEARS
AT THIS
ADDRESS 
COMPLETE FOR JOINT CREDIT, SECURED CREDIT OR IF YOU LIVE IN A COMMUNITY PROPERTY STATE:
   
MARRIED
   
SEPARATED
   
UNMARRIED (Single - Divorced - Widowed)
      EMPLOYMENT/INCOME     
NAME AND
ADDRESS OF
EMPLOYER
TITLE/GRADE START DATE HOURS AT WORK
SUPERVISOR'S NAME IF SELF EMPLOYED, TYPE OF BUSINESS
NOTICE:  : ALIMONY CHILD SUPPORT, OR SEPARATE MAINTENANCE INCOME NEED NOT BE REVEALED IF YOU DO NOT CHOOSE TO HAVE IT CONSIDERED
EMPLOYMENT INCOME OTHER INCOME
$_______________ PER_______________ $_______________ PER_______________
   
NET
   
GROSS
  SOURCE______________________________
MILITARY: IS DUTY STATION TRANSFER EXPECTED DURING NEXT YEAR?
   
YES 
   
NO 
WHERE ENDING/SEPARATION DATE
PREVIOUS EMPLOYER NAME AND ADDRESS IF EMPLOYED LESS THAN FIVE YEARS

STARTING DATE
_________________
ENDING DATE

Applicant Reference
NAME AND ADDRESS
OF NEAREST
RELATIVE NOT
LIVING WITH YOU
RELATIONSHIP__________________________________
_______________________________________________
PHONE_________________________________________

Other Reference
NAME AND ADDRESS
OF NEAREST
RELATIVE NOT
LIVING WITH YOU
RELATIONSHIP__________________________________
_______________________________________________
PHONE_________________________________________

What You Owe

CREDITOR NAME OTHER THAN THIS CREDIT UNION
(Attach additional sheet(s) if necessary)

INTEREST
RATE
PRESENT
BALANCE
MONTHLY
PAYMENT
OWED BY
Applicant Other
__Rent__1st Mortgage
(Include Tax & Ins.)
    $ $    
2nd Mortgages     $ $    
1st Auto Loan     $ $    
2nd Auto Lone     $ $    
Child-Care     $ $    
Child Support     $ $    
Credit Card     $ $    
Credit Card     $ $    
Credit Card     $ $    
Credit Card     $ $    
Credit Card     $ $    
Other     $ $    
Other     $ $    
List any names under which your credit references and credit history can be checked: TOTALS $ $    
 
Other Information About You

IF YOU ANSWER "YES" TO ANY QUESTION OTHER THAN #1,
EXPLAIN ON AN ATTACHED SHEET

APPLICANT OTHER
YES NO YES NO
1ARE YOU A U.S. CITIZEN OR PERMANENT RESIDENT ALIEN?
       
2. DO YOU CURRENTLY HAVE ANY OUTSTANDING JUDGMENTS OR HAVE YOU EVER FILED FOR BANKRUPTCY, HAD A DEBT ADJUSTMENT PLAN COFIRMED UNDER CHAPTER 13, HAD PROPERTY FORECLOSED UPON OR REPOSSESSED IN THE LAST 7 YEARS, OR BEEN A PARTY IN A LAWSUIT?
       
3. IS YOUR INCOME LIKELY TO DICLINE IN THE NEXT TWO YEARS?
       
4. ARE YOU A CO-MAKER, CO-SIGNER OR GUARANTOR ON ANY LOAN NOT LISTED ABOVE?


FOR WHOM? (Name of others obligated on loan): 



 
                                
       
TO WHOM? (Name of creditor):




       
Signatures
You promise that everything you have stated in this application is correct to the best of your knowledge. If there are any important changes you will notify use in writing immediately. You authorize the Credit Union to obtain credit reports in connection with this application for credit and any update, increase, renewal or extension of the credit received. You understand that the Credit Union will rely on the information in this application and your credit report to make its decision. If you request, the Credit Union will tell you the name and address of any credit bureau from which it received a credit report on you. It is a federal crime to willfully and deliberately provide incomplete or incorrect information on loan applications made to federal credit unions or state chartered credit unions insured by NCUA.
       
X __________________________________________    
  Applicants Signature                          Date    
       
X __________________________________________    
  Other Signature                                 Date    
For Credit Union Use Only
DATE     
   
APPROVED DEBT RATIO/SCORE  
 
   
DENIED (Adverse Action Notice Sent) BEFORE      AFTER  
LOAN OFFICER COMMENTS:_______________________________________________________
__________________________________________________________________________
__________________________________________________________________________
 
Signature:
X_______________________________________
                                                                     Date
Signature:
X_______________________________________
                                                                     Date
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