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Fellowship Credit Union Membership

Fellowship Credit Union Loan Application

General Information

Individual Credit: You must complete the Applicant section about yourself and Co-Application section about your spouse if:

  1. you live in or the property pledged as collateral is located in a Community Property State. (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: Each applicant must individually complete the appropriate section below. If Other is the spouse of the Applicant, mark the Co-Applicant box.

Guarantor: complete the Other section if you are a guarantor on an account/loan.

* Required Field
  Are you applying for Joint or Individual Credit?

* Loan Amount Requested
* Purpose of the Loan
* Collateral

Payment Protection

  Payment Protection Plan


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

* Last Name
  Middle Name
* First Name
  Account Number
* Social Security Number - -
* Driver's License Number
* Driver's License State
  List Ages of Dependents Not Listed By Other Applicant (Excludes Self)
* Date of Birth / / (mm/dd/yyyy)
* Home Phone Number() -
  Work Phone Number() - ext
  Other Phone Number() - ext
* Email Address

Applicant - Current Address

* Street Address
  Apt
* City
* State
* Zip Code
* Years At This Address
  Residence Type

* Monthly Rent/Mortgage
* Mortgage/Rent Owed to
* Mortgage Balance
  Interest Rate

Applicant - Previous Address

  Street Address
  City, State, Zip
  Resident Type

  Years at This Address
  COMPLETE FOR JOINT CREDIT, SECURED CREDIT, OR IF YOU LIVE IN A COMMUNITY PROPERTY STATE.


Applicant - Employment/Income

  Company
  Company Address
  Title/Grade
  Job Start Date / / (mm/dd/yyyy)
  Hours At Work
  Supervisor's Name
  If Self Employed Type of Business

Alimony, child support, or separate maintenance income need not be revealed if you do not wish to have it considered as a basis for repaying this obligation.

  Gross Salary
  Salary is per


  Other Income
  Income is per


  Other Income Source

Military:

  Is Duty Station Transfer Expected During Next Year?

  If yes, where
  Ending / Separation Date / / (mm/dd/yyyy)

Previous Employer (If Employed Less Than Five Years)

  Name
  Address
  Starting Date / / (mm/dd/yyyy)
  Ending Date / / (mm/dd/yyyy)

Applicant Reference (Nearest Relative Not Living With You)

  Name
  Address
  Relationship
  Home Phone() -

Other

  Other Applicant is:


  Last Name
  Middle Name
  First Name
  Account Number
  Social Security Number - -
  Driver's License Number
  Driver's License State
  List Ages of Dependents Not Listed by Applicant (Exclude Self)
  Date of Birth / / (mm/dd/yyyy)
  Home Phone Number() -
  Work Phone Number() - ext
  Other Phone Number() - ext
  Email Address

Other - Current Residence

  Street Address
  Apt
  City
  State
  Zip Code
  Current Time at Residence
  Residence Type

  Monthly Rent/Mortgage
  Mortgage/Rent Owed to
  Mortgage Balance
  Interest Rate

Other - Previous Address

  Address
  City, State, Zip
  Resident Type

  Years at this Address
  COMPLETE FOR JOINT CREDIT, SECURED CREDIT, OR IF YOU LIVE IN A COMMUNITY PROPERTY STATE.


Other - Employment/Income

  Company
  Company Address
  Title/Grade
  Job Start Date / / (mm/dd/yyyy)
  Hours at Work

Alimony, child support, or separate maintenance income need not be revealed if you do not wish to have it considered as a basis for repaying this obligation.

  Gross Salary
  Salary is per


  Other Income
  Income is per:


  Other Income Source

Military - Other Applicant

  Is Duty Station Transfer Expected During Next Year?

  If yes, where
  Starting Date / / (mm/dd/yyyy)
  Ending Date / / (mm/dd/yyyy)

Other Applicant - Previous Employer (If Employed Less Than Five Years)

  Name
  Address
  Starting Date / / (mm/dd/yyyy)
  Ending Date / / (mm/dd/yyyy)

Other Applicant - Reference (Nearest Relative Not Living With You)

  Name
  Address
  Relationship
  Home Phone() -

What You Owe

Please place an X in the Applicant or Other box to indicate who owes this debt.

Creditor Name Other Than This Credit Union

 Creditor NameInterest RatePresent BalanceMonthly PaymentApplicantOther
2nd Mortgage
1st Auto Loan
2nd Auto Loan
Child Care
Child Support
Credit Card
Credit Card
Other
Other
  Total Present Balance
  Total Monthly Payment
  List Any Names Under Which Your Credit References and Credit History Can Be Checked

What You Own

List Location of Property or Financial Institution

 LocationMarket Value $Pledged Collateral YesPledged Collateral
No		ApplicantOther
Home
Auto
Savings
Checking
Other

Other Information About - Applicant

If You Answer "Yes" To Any Question Other Than #1, Explain below.

  1. Are You A U.S. Citizen or Permanent Resident Alien?

  2. Do you currently have any outstanding judgements, have you ever filed for bankruptcy, had a debt adjustment plan confirmed under chapter 13, had property foreclosed upon or repossessed in the last 7 years, or been a party to a lawsuit?
  3. Is your income likely to decline 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)

Other Information About - Other

If You Answer "Yes" To Any Question Other Than #1, Explain below.

  1. Are You A U.S. Citizen or Permanent Resident Alien?

  2. Do you currently have any outstanding judgements, have you ever filed for bankruptcy, had a debt adjustment plan confirmed under chapter 13, had property foreclosed upon or repossessed in the last 7 years, or been a party to a lawsuit?
  3. Is your income likely to decline 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)

State Law Notices

Ohio Residents Only: The Ohio laws against discrimination require that all creditors make credit 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.

Wisconsin Residents Only: (1) No provision of any marital property agreement unilateral statement under Section 766.59, or course decree under Section 766.70 will adversely affect the rights of the Credit Union unless the Credit Union is furnished with a copy of the agreement, statement or decree, or has actual knowledge of the terms, before the credit is granted or the account is opened. (2) Please intial below 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.

  Applicant Initials for Wisconsin Residents Only

Agreement

Initial below to 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 us in writing immediately. You authorize the Fellowship Credit Union to obtain credit reports in connection with the application for credit and for any update, increase, renewal, extension, or collection of the credit received. You understand that the Fellowship 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.

* Applicant Initials
  Other Applicant Initials
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Equal Housing Lender National Credit Union Administration This Credit Union is federally-insured by the National Credit Union Administration.
We do business in accordance with the Fair Housing Law and Equal Opportunity Credit Act.
NMLS ID# 854270