Loan Application Extended


Please use the following form to submit the additional information for your consumer loan information to the credit union:

* Indicates required field. Comments or questions are welcome.

ASSETS
Name *
Name
Pledged as Collateral for Another Loan
DEBTS
OTHER INFORMATION
Do you have any outstanding judgments? *
Co-applicant? *
Have you ever filed for bankruptcy or had a debt adjustment plan confirmed under Chapter 13? *
Co-applicant? *
Have you had property foreclosed upon or repossessed in the last 7 years? *
Co-applicant? *
Are you a party in a lawsuit? *
Co-applicant? *
Are you other than a U.S. Citizen or permanent resident alien? *
Is your income likely to decline in the next two years? *
Are you a co-maker co-signer or guarantor on any loan not listed above? *
SIGNATURE
If there are any important changes, you will notify us in writing immediately. You also agree to notify us of any change in your name, address or employment within a reasonable time thereafter. You also promise that everything you have stated in this application is correct to the best of your knowledge and that the above information is a complete listing of all your debts and obligations. You authorize the credit union to obtain credit reports in connection with this application for credit and for any update, renewal or extension of the credit received. 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. You understand that 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. The USA Patriot Act requires that we obtain, verify, and record information that identifies each person who opens an account. 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 Agreement, and you further understand that any changes in this address must be submitted to us in writing to be effective.