Loan Application

• Step

  Loan Information

  • Loan Type *
    Personal Loan New Car Used Car Recreational Vehicle Auto Refinance Share Secured
  • Vehicle Identification Number*
  • Collateral Description *
  • Loan Amount *
  • Payment Method *
    Transfer Payment Auto Deduction/Payroll ACH Debit from Other Financial Institution Cash/Check
  • Length of Loan *in months
  • Payment Amount Requested *
  • Repayment Scheduled*
    Monthly Semi Monthly Biweekly Weekly
  • Loan Purpose *
  • Application Type *
    Individual Joint
• Step

  Applicant Information

  • First Name *
  • Last Name *
  • Date of Birth *
  • Account Number *
  • Social Security Number *
  • Driver's License Number
  • Drivers License State
    Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming
  • Phone*
    Cell Home
  • Cell Phone *
  • Home Phone *
  • Secondary Phone*
    Cell Home Work
  • Cell Phone *
  • Home Phone *
  • Work Phone *
  • Email *
  • Preferred Contact Method *
    Work Home Cell Secondary Cell Email
  • Address *
  • Address
  • City *
  • State *
    Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming
  • Zip *
  • Housing Type*
    Own Rent Other
  • Years and Months at address *
  • Mortgage Holder or Landlord Name
  • Monthly Rent/Mortgage Payment
  • Payment Type
    Rent/Board Mortgage
  • Mortgage Balance

  If less than 2 years at current address:

  • Previous Address
  • Previous Address
  • Previous City
  • Previous State
    Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming
  • Previous Zip

  Employment Information

  • Employment Type *
    Employed Self Employed Retired Unemployed
  Full time or Part time? *
  Full Time Part Time
  Part Time Hours *
  Job Title *
  Employer Name *
  Employer Address *
  Employer City *
  Employer State *
  Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming
  Employer Zip *
  Employer Phone *
  Years and months at job *
  Gross salary per pay period *
  Pay frequency *
  Monthly Bi-weekly Weekly Semi-monthly
  Estimated Self Employment Income *
  Self Employment Pay frequency *
  Monthly Bi-weekly Weekly Semi-monthly
  Estimated Retirement Income *
  Retirement Pay frequency *
  Monthly Bi-weekly Weekly Semi-monthly

  If employed for less than 2 years at your current job:

  • Previous Employer Name
  • Previous Employer Address
  • Previous Employer City
  • Previous Employer State
    Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming
  • Previous Employer Zip
  • Previous Years and months at job

  Additional Income

  • Other Income Source
    Second Job Overtime Parttime Rental income Alimony Child Support Maintenance Retirement Income
  • Estimated Income Amount
  • Pay frequency
    Monthly Bi-weekly Weekly Semi-monthly

  Additional Income

  • Other Income Source
    Second Job Overtime Parttime Rental income Alimony Child Support Maintenance Retirement Income
  • Estimated Income Amount
  • Pay frequency
    Monthly Bi-weekly Weekly Semi-monthly

  Joint Applicant Information

  • First Name *
  • Last Name *
  • Date of Birth *
  • Account Number *
  • Social Security Number *
  • Driver's License Number
  • Drivers License State
    Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming
  • Phone*
    Cell Home
  • Cell Phone *
  • Home Phone *
  • Secondary Phone*
    Cell Home Work
  • Cell Phone *
  • Home Phone *
  • Work Phone *
  • Email *
  • Preferred Contact Method *
    Work Home Cell Secondary Cell Email
  • Address *
  • Address
  • City *
  • State *
    Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming
  • Zip *
  • Housing Type*
    Own Rent Other
  • Years and Months at address *
  • Mortgage Holder or Landlord Name
  • Monthly Rent/Mortgage Payment
  • Payment Type
    Rent/Board Mortgage
  • Mortgage Balance

  If less than 2 years at current address:

  • Previous Address
  • Previous Address
  • Previous City
  • Previous State
    Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming
  • Previous Zip

  Employment Information

  • Employment Type *
    Employed Self Employed Retired Unemployed
  Full time or Part time? *
  Full Time Part Time
  Part Time Hours *
  Job Title *
  Employer Name *
  Employer Address *
  Employer City *
  Employer State *
  Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming
  Employer Zip *
  Employer Phone *
  Years and months at job *
  Gross salary per pay period *
  Pay frequency *
  Monthly Bi-weekly Weekly Semi-monthly
  Estimated Self Employment Income *
  Self Employment Pay frequency *
  Monthly Bi-weekly Weekly Semi-monthly
  Estimated Retirement Income *
  Retirement Pay frequency *
  Monthly Bi-weekly Weekly Semi-monthly

  If employed for less than 2 years at your current job:

  • Previous Employer Name
  • Previous Employer Address
  • Previous Employer City
  • Previous Employer State
    Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming
  • Previous Employer Zip
  • Previous Years and months at job

  Additional Income

  • Additional Income
  • Other Income Source
    Overtime Parttime Rental income Alimony Child Support Maintenance Retirement Income
  • Additional Income Gross Monthly Amount
  • Pay frequency
    Monthly Bi-weekly Weekly Semi-monthly

  Additional Income

  • Additional Income
  • Other Income Source
    Overtime Parttime Rental income Alimony Child Support Maintenance Retirement Income
  • Additional Income Gross Monthly Amount
  • Pay frequency
    Monthly Bi-weekly Weekly Semi-monthly
• Step

  Debts

  • Creditor Name
  • Liability Type
    Installment Revolving Mortgage
  • Loan Balance
  • Monthly Payment

  Additional Outstanding Debts

  • Creditor Name
  • Liability Type
    Installment Revolving Mortgage
  • Loan Balance
  • Monthly Payment

  Property Owned

  Home

  • Date Purchased
  • Purchase Price
  • Current Market Value
  • In whose name

  Automobile 1

  • Year, Make & Model
  • Financed By
  • Balance Owning
  • Monthly Payment

  Automobile 2

  • Year, Make & Model
  • Financed By
  • Balance Owing
  • Monthly Payment
• Step

  References & Agreement

  • Reference Type*
    Friend Relative
  • Reference Name *
  • Reference Phone *
  • Reference Address *
  • Reference City *
  • Reference State
    Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming
  • Reference Zip
  • Do you have any outstanding judgments? *
    Yes No
  • Have you ever filed for bankruptcy or had a debt adjustment plan confirmed under Chapter 13?*
    Yes No
  • Have you had property foreclosed upon or repossessed in the last 7 years?*
    Yes No
  • Are you other than a U.S. Citizen or permanent resident alien? *
    Yes No
  • Is your income likely to decline in the next two years? *
    Yes No
  • Are you a co-maker, co-signer or guarantor on any loan not listed above? *
    Yes No
  • If yes, what is the monthly payment *
  • Are you liable for alimony, child support or maintenance programs? *
    Yes No
  • If yes, what is the monthly payment *

  I/We agree to the terms and conditions of the Loan Agreement, Truth-in-Savings Disclosure, Funds availability Policy Disclosure, if applicable, and to any amendment the Credit Union makes from time to time which are incorporated herein. I/We acknowledge receipt of a copy of the agreements and disclosures applicable to the accounts and services requested herein. If an access card or EFT service is requested and provided, I/we agree to the terms of and acknowledge receipt of the Electronic Fund Transfers Agreement and Disclosure. The Internal Revenue Service does not require your consent to any provision of this document other than the certifications required to avoid backup withholding. I/We grant persmission to United Equity Credit Union to check mine/our credit report and check mine/our employment and references.

  • Office Preference *
    Decatur-Pershing Rd. Decatur-William St. Galesburg No Preference
  • Primary Applicant Date *

  • Joint Applicant Date *