Locoga Federal Credit Union
1592 Norman Drive
Valdosta, GA 31601
Fax: (229)
244-5995 |
LOAN
APPLICATION |
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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: |
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Individual |
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Joint |
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Amount Requested $:___________________ |
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Purpose/Collateral:_______________________________________________________________________________________ |
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Repayment: |
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Payroll
Deduction |
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Cash
|
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Military
Allotment |
|
Automatic
Payment |
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Other
______________ |
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Single
Credit Disability Insurance |
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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. |
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|
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
|
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|
PREVIOUS
ADDRESS (Street - City - State - Zip) |
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OWN
|
|
RENT
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COMPLETE
FOR JOINT CREDIT, SECURED CREDIT OR IF YOU LIVE IN A COMMUNITY
PROPERTY STATE: |
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MARRIED |
|
SEPARATED |
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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_______________ |
|
|
SOURCE______________________________ |
|
MILITARY:
IS DUTY STATION TRANSFER EXPECTED DURING NEXT YEAR?
|
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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
|
|
|
|
PREVIOUS
ADDRESS (Street - City - State - Zip) |
|
OWN
|
|
RENT
|
|
|
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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_______________ |
|
|
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
|
|
|
NAME AND
ADDRESS
OF NEAREST
RELATIVE NOT
LIVING WITH YOU |
RELATIONSHIP__________________________________ |
_______________________________________________ |
PHONE_________________________________________ |
|
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 |
|
|
$ |
$ |
|
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2nd Auto
Lone |
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|
$ |
$ |
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Child-Care |
|
|
$ |
$ |
|
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Child Support |
|
|
$ |
$ |
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|
Credit
Card |
|
|
$ |
$ |
|
|
Credit
Card |
|
|
$ |
$ |
|
|
Credit
Card |
|
|
$ |
$ |
|
|
Credit
Card |
|
|
$ |
$ |
|
|
Credit
Card |
|
|
$ |
$ |
|
|
Other |
|
|
$ |
$ |
|
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Other |
|
|
$ |
$ |
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List
any names under which your credit references and credit history
can be checked: |
TOTALS |
$ |
$ |
|
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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? |
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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? |
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3.
IS YOUR INCOME LIKELY TO DICLINE IN THE NEXT TWO YEARS? |
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4.
ARE YOU A CO-MAKER, CO-SIGNER OR GUARANTOR ON ANY LOAN NOT LISTED
ABOVE?
FOR WHOM? (Name of others obligated on loan):
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TO WHOM? (Name of creditor):
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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. |
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X |
__________________________________________ |
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Applicants
Signature Date |
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X |
__________________________________________ |
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Other
Signature Date |
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For
Credit Union Use Only |
DATE |
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APPROVED |
DEBT
RATIO/SCORE |
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DENIED (Adverse Action Notice Sent) |
BEFORE AFTER |
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LOAN
OFFICER COMMENTS:_______________________________________________________ |
__________________________________________________________________________ |
__________________________________________________________________________ |
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Signature:
X_______________________________________
Date |
Signature:
X_______________________________________
Date |
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You
Must Print, Sign, and Return to Credit Union
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