Loan Application - Capital Area Federal Credit Union

Capital Area FCU Secure Loan Application Form

Loan Amount *

Purpose of Loan *

Collateral Offered

Type of Credit *

Individual Credit
Joint Credit

Joint Application?

Yes (Please also provide information about joint owner)

APPLICANT

Marital Status *

Married
Separated
Unmarried

Name *

First Middle Initial Last

Date of Birth *

Social Security # *

Email Address *

Enter Email Confirm Email Address

Home Phone Number *

Applicant Street Address *

Street Address Address Line 2 City State ZIP Code

Years *

EMPLOYMENT AND INCOME

Current Employer *

Street Address *

Street Address Address Line 2 City State ZIP Code

Hire Date *

Work Phone Number *

Monthly Gross Income *

Position *

Supervisor's Name *

Supervisor's Phone *

OTHER INCOME

You need not list income from alimony, child support or separate maintenance unless you wish it considered for purposes of granting this credit.

Source of Other Income 1

Home Phone Number

Monthly Income

CO-APPLICANT

Guarantor

Yes

Marital Status

Married
Separated
Unmarried

Name

First Middle Initial Last

Date of Birth

Social Security #

Home Phone Number

Current Street Address

Street Address Address Line 2 City State ZIP Code

Years

CO-APPLICANT: Employment & Income

Current Employer

Street Address

Street Address Address Line 2 City State ZIP Code

Hire Date

Work Phone Number

Monthly Gross Income

Position

Supervisor's Name

Supervisor's Phone

CO-APPLICANT: Other Income

You need not list income from alimony, child support or separate maintenance unless you wish it considered for purposes of granting this credit.

Source of Other Income 1

Home Phone Number

Monthly Income

MORTGAGE OR RENT

Mortgage/Rent 1 *

Applicant
Other

Creditor Name *

Creditor Address *

Street Address Address Line 2 City State ZIP Code

Rent or Own? *

Rent
Own

Monthly Payment Amount *

I have additional mortgage/rent information to enter

Yes

MORTGAGE OR RENT #2

Mortgage/Rent

Applicant
Other

Creditor Name

Creditor Address

Street Address Address Line 2 City State ZIP Code

Rent or Own?

Rent
Own

Monthly Payment Amount

MORTGAGTE/RENT #3

Mortgage/Rent

Applicant
Other

Creditor Name

Creditor Address

Street Address Address Line 2 City State ZIP Code

Rent or Own?

Rent
Own

Monthly Payment Amount

ANSWER THE FOLLOWING QUESTIONS

If a "Yes" answer is given to a question, explain below

Have you any outstanding judgements?

Applicant *

YES
NO

Other

YES
NO

Have you ever filed for bankruptcy or had a debt adjustment plan confirmed under chapter 13?

Applicant *

YES
NO

Other

YES
NO

Have you had a property foreclosed upon or reposessed in the last 7 years?

Applicant *

YES
NO

Other

YES
NO

Are you a party to a lawsuit?

Applicant *

YES
NO

Other

YES
NO

Are you other than a U.S. citizen or permanent resident alien?

Applicant *

YES
NO

Other

YES
NO

Is your income likely to decline in the next two years?

Applicant *

YES
NO

Other

YES
NO

Are you a co-maker, co-signer or guarantor on any loan?

Applicant *

YES
NO

Other

YES
NO

If yes to any of the above, please explain

Notice

You agree and attest that your name and address shown herein is your legal name and the place of your residence, and such address is the proper address for all notice(s) required by this Application, and you further understand that any changes in this address must be submitted to us in writing to be effective. You agree that everything stated in this application, whether oral, written, or through a FAX machine, is true and correct to the best of your knowledge. The Credit Union or its agent is authorized to investigate your credit worthiness, employment history, and to obtain a credit report and to answer questions about their credit history with you. You understand that any false or misleading statements in your application may cause any loan to be in default. You agree that this application shall be the Credit Union's property whether or not this Credit Application is approved. You will notify us, in writing, immediately of any changes in your name, address or employment within a reasonable time. You understand that it is a federal crime to willfully and deliberately provide incomplete or incorrect information to obtain credit. If you request, we will provide you with the name and address of any credit bureau from which it received a credit report. If this application is used to issue a credit card, my signature or using or allowing the card to be used means that I agree to be bound by all terms and conditions of the card agreement provided to me.