For a
pre-approved loan, complete the online form and print it on your
printer and mail or fax the printout to the credit union. Do NOT email this application to the credit union.
Fax: (504) 257-4216
Phone:(504) 257-4206
We would
like an initial loan in the amount of
$
For the
following purpose:
Application Date: 9/5/2008
Account No.
A. APPLICANT'S PERSONAL
INFORMATION
Check
one if you reside in or are relying on property in a community
property state or if you are applying for other than
individual unsecured credit:
Married
Unmarried
Separated
Last Name
First Name
Initial
Date of Birth
Social Security
Number
Present Street Address
City
State
Zip
How
Long?
Home
Phone Number
Ages of
Previous Street Address
City
State
Zip
How
Long?
Driver's License # & ST
Dependents
B. INFORMATION
REGARDING APPLICANT
Present Employer
Address
City
State
Zip
Date
Employed
Occupation
Work
Phone & Ext
Supervisor's Name
Supervisor's Phone
Gross
Pay
$
Previous Employer
Address
City
State
Zip
Date
Employed
Real
Estate Owned (include home)
Address
City
State
Zip
How
Long?
Purchase Price
Date Purchased:
Other
Income Notice
Do not list alimony, child or spousal support or separate
maintenance payments unless you wish them considered as a
basis for repayment of the credit requested. If listed,
verification may be requested.
Source of Other
Income
Amount
$
Total Monthly
Income
$
C. INFORMATION
REGARDING SPOUSE OR CO-APPLICANT
PLEASE READ BEFORE
COMPLETING. COMPLETE THIS SECTION 1. If you reside in a
Community Property State, or 2. If you are relying on property
located in a Community Property State as a basis for repayment of
the credit requested, or 3. If you are relying on your
co-applicant's income as a basis for repayment of the credit
requested, or 4. If your co-applicant will be contractually liable
on the loan, or 5. If you are relying on alimony, child support or
separate maintenance payments from a spouse or former spouse as a
basis for repayment of the credit requested. Community
property states include: Arizona, California, Idaho, Louisiana New
Mexico, Nevada, Texas and Washington.
Spouse
Former
Spouse
Co-Applicant
Last Name
First Name
Initial
Driver's License &
ST
Social Security
Number
Street Address
City
State
Zip
How
Long?
Date
of Birth
Occupation
Present Employer
Work
Phone & Ext
Supervisor's Name
Supervisor's Phone
Date
Employed
Other
Income Notice
Do not list alimony, child or spousal support or separate
maintenance payments unless you wish them considered as a
basis for repayment of the credit requested. If listed,
verification may be requested.
Source of Other
Income
Amount
$
Total Monthly
Income
$
D. LIST ALL
EXISTING DEBTS OF APPLICANT (and spouse or co-applicant if any
part of sections C is applicable)
Name of Creditor
ADDRESS AND CITY
PURPOSE OR ACCT #
ORIGINAL AMOUNT
PRESENT BALANCE
MONTHLY PAYMENT
Home Mortgage or Landlord
Address and City
Renting
Buying
Original Amount
$
Present Balance
$
Monthly Payment
$
Credit Union
$
$
$
Credit Card
$
$
$
Other
$
$
$
$
$
$
$
$
$
$
$
$
Automobile Make
Model
Year
License No
Financed By
Present Balance
$
Monthly Payment
$
Automobile Make
Model
Year
License No
Financed By
Present Balance
$
Monthly Payment
$
List alimony, child support or child
care paid monthly
$
DO NOT OMIT ANY DEBTS!
INCOMPLETE APPLICATIONS CANNOT BE PROCESSED. Attach
additional sheet if necessary
Totals should include all debt --->
Total Monthly Oblications
$
If you answer Yes to any of
these questions, please provide details.
Is your income likely to decline in
the next two years?
Yes
No
Are any of your debts past due?
Yes
No
Have you ever had your auto, furniture
or property repossessed?
Yes
No
Have you or your co-applicant declared
bankruptcy?
Yes
No
Are you currently a co-maker on a
loan?
Yes
No
PLEASE READ BEFORE
SIGNING All of the information on this application is true. I
understand that 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.. If there are any important changes ,I will
notify the credit union in writing immediately. I authorize the
Credit Union to check the information I have given, and to obtain
credit reports in connection with this application for credit and
for any update, renewal or extension of the credit received . I
understand that the Credit Union will rely on the information in
this application and the credit report to make its decision. The
credit Union may retain this application if it is not approved .
If it is approved, I agree to honor the provisions of the credit
agreement covering my loan or account. If this application is for
two of us , this statement applies to both of us.
APPLICATION
SHOULD BE ACCOMPANIED BY A COPY OF THE LAST PAY STUB ON ALL
APPLICANTS AND CO-APPLICANTS
AND A $15.00 (NON-REFUNDABLE) LOAN PROCESSING FEE PER APPLICANT.
Signature of Applicant
Date
Signature of Co-Applicant
Date
The following parties hereby
certify that they are applying for joint credit .
Signature of Joint Applicant
Date
Signature of Joint Applicant
Date
After you have completed
filling out the application, click the Print button on your browser to
print this application to your printer. Mail or fax the printed
application using the address or fax number at the top of this
application along with a copy of your last pay stub on all applicants
and co-applicants. Also include any additional sheets listing
additional debt.