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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: Amount Requested $:
Provide information about both of you by completing Applicant and Co-Applicant sections. NOTE: The Credit Union cannot consider you as a co-borrower if you are not a Credit Union member. You will be considered a co-signer or guarantor unless you make arrangements to become a Credit Union member.
(Including ATM/Debit Card access to the account if Available)
APPLICANT NAME (last - first - Initial) MOTHER'S MAIDEN NAME
SOCIAL SECURITY NUMBER
DRIVER'S LICENSE NUMBER DL STATE
BUSINESS PHONE / EXT.
PRESENT ADDRESS (Street - City - State - Zip)
YEARS AT THIS ADDRESS
MORTGAGE/RENT OWED TO:
MORTGAGE BALANCE $ MONTHLY PAYMENT INTEREST RATE $
NAME AND ADDRESS OF EMPLOYER
NOTICE: ALIMONY CHILD SUPPORT, OR SEPARATE MAINTENANCE INCOME NEED NOT BE REVEALED IF YOU DO NOT CHOOSE TO HAVE IT CONSIDERED
EMPLOYMENT INCOME $ EMPLOYMENT INCOME FREQUENCY NET GROSS
OTHER INCOME $
OTHER INCOME FREQUENCY
Co-Applicant Spouse Guarantor
CO-APP NAME (last - first - Initial)
CO-APP MOTHER'S MAIDEN NAME
CO-APP ACCOUNT NUMBER
CO-APP SOCIAL SECURITY NUMBER
CO-APP DRIVER'S LICENSE NUMBER
CO-APP DRIVER'S LICENSE STATE
CO-APP BIRTH DATE
CO-APP HOME PHONE
CO-APP BUSINESS PHONE / EXT.
CO-APP E-MAIL ADDRESS
CO-APP PRESENT ADDRESS (Street - City - State - Zip)
CO-APP YEARS AT THIS ADDRESS
CO-APP MORTGAGE/RENT OWED TO:
CO-APP MORTGAGE BALANCE $
CO-APP MONTHLY PAYMENT
CO-APP INTEREST RATE $
CO-APP EMPLOYER NAME AND ADDRESS
CO-APP START DATE
CO-APP EMPLOYMENT INCOME
CO-APP EMPLOYMENT INCOME PER
CO-APP OTHER ICOME
CO-APP OTHER INCOME PER
STATE LAW NOTICES
RESIDENTS ONLY: The Ohio laws against discrimination require
that all creditors make credit equally available to all creditworthy
customers, and that credit reporting agencies maintain separate
credit histories on each individual upon request. The Ohio
Civil Rights Commission administers compliance with this law.
RESIDENTS ONLY: (1) No provision of any marital property
agreement, unilateral statement under Section 766.70, or
court decree under 766.70 will adversely affect the rights
of the Credit Union unless the Credit Unions furnished a
copy of the agreement, statement or decree, or has actual
knowledge of its terms, before the credit is granted or
the account is opened. (2) Please sign if you are not applying
for this account or loan with your spouse. The credit being
applied for, if granted, will be incurred in the interest
of the marriage or family of the undersigned.
By submitting this application to the Credit Union,
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.
By submitting this application electronically, I/we
agree to the same terms that apply to a signed application.
If there is a co-applicant on this loan, that co-applicant
has authorized the submission of this application.
This electronic submission qualifies as my/our signature.