Application - Israel Methcomm Federal Credit Union

Application for Credit Union Loan

Personal Information

Name

Home Phone

Last four digits of SSN

Address

City

State

Zip

Date of Birth

No. of Dependents

Marital Status (complete only if loan is for secured credit)

Unmarried Married Separated

Are you liable for alimony, child support or separate maintenance payments?

Yes No

Amount per month

Are you relying on income from another person to repay this loan?

Yes No

If yes, Name

Are you a comaker on any other loans?

Yes No

If yes, for whom

Loan Amount Requested

Repayment Term

Weekly Bi-Weekly Monthly Semi-Monthly

Repayment Amount

Interest

Including Interest Plus Interest

I desire this loan for the following purpose (explain fully):

Have you even been through bankruptcy less than 10 years ago?

Yes No

Have you any Judgments, Garnishments or Legal Proceedings against you?

Yes No

Please Explain Fully

Length of time at present address

List of all addresses for past 5 years:

Bank Reference

Checking Savings

You need NOT disclose the following sources of income; but if you want the credit union to consider such income in connection with this loan application, please complete the following:

Collateral Offered

Shares Automobile Other

Owners' Names

Amount of Shares Pledged

Description of Auto

Auto Owned

Make

Year

2nd Auto Owned

Make

Year

Drivers License No.

Reasonable Market Value of Real Estate Owned

Date of Birth

No. of Dependents

Employment Details

Employer

Address

Position

Date Employed

Monthly Income (after taxes)

Other personal income (do NOT include alimony, child support or separate maintenance payments)

Alimony

Child Support

Installment Amounts

Separate Maintenance

Person Liable

To Whom Owed

Purpose

Name & Address

Date Of Load

Original Amount

Present Balance

Monthly Payment

Add more...

Totals

CO-MAKER'S STATEMENT

To the ------Credit Union

Date

Having read the foregoing application for a personal loan and being willing to become a co-maker with ------- for the desired loan I will sign the note which will evidence the loan if granted I fully understand the responsibility which is assumned by signing the note

Present Address

How Long

Tel. No.

Former Address

No. of dependents

Employer's name

Address

Tel. No.

Type of business

Number of years with employer

Position occupied

Name and title of superior

Income: Salary, wages, or commisions per month $

Other personal income (do NOT include alimony, chiild support or separate maintenance payment) $

You need NOT disclose the following sources of income; but if you want the credit union to consider such income in connection with this loan application.please complete the following:

Alimony $

Child Support $

Separate Maintenance $

Person Liable $

Person Reference

Address

Personal Bank Account:

Commercial

Amount $

Savings

Amount $

Name of Bank

Address

Real Estate - Location and description:

Title in name of

Purchase price

Balance of Mortgage

Monthly Payment

How long have you known applicant?

Are you the spouse of the applicant?

Yes No

Are you a co-maker on other loans?

Yes No

Amount $

Total outstanding debts (except mortgage) $

Monthly payment on debts $

Date of Birth

I certify the above information is true and correct

Signature of Co-Maker

Social Security No.

Where You’re More than a Customer…You’re an Owner!

Serving Members Since 1963

Israel Methcomm Federal Credit Union

Application for Credit Union Loan

Personal Information

Auto Owned

2nd Auto Owned

Employment Details

CO-MAKER'S STATEMENT

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