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VISA Application

Please Click Here for Cardholder Agreement and Disclosures
Please Click Here for Rate Information

* Required Fields
This application initiates the loan process. Final signature(s) will be required to advance funds, including signatures for joint applicants. Please contact us after 4:30 of the day that the application is sent or the next business day if it is after 2:00 pm Eastern time.

PLEASE TELL US ABOUT YOURSELF (PRIMARY BORROWER)


Birth Date:
 /   / 
PLEASE TELL US ABOUT YOUR JOB (PRIMARY BORROWER)
Note: 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
PLEASE TELL US ABOUT YOURSELF (CO-BORROWER)

PLEASE TELL US ABOUT YOUR JOB (CO-BORROWER)
Note: 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
PLEASE LIST NEAREST RELATIVE NOT LIVING WITH YOU
IF APPLYING FOR A PERSONAL UNSECURED LOAN SUCH AS VACATION OR OTHER PLEASE SELECT A FORM OF COLLATERAL

MONTHLY PAYMENTS

Mortgage
Rent
Auto
Auto 2
Charge Card
Other
Other
Other
Are you a Co-Borrower on any other loans?
Loan Application Disclosure of Terms and Conditions
I/we accept and consent to the loan application disclosure information outlined below. I/we further agree that if this application is approved and
subsequently executed,that I/we agree to a $25.00 Loan Fee, and that I/we will accept and sign an original application form with the same written
disclosure information included therein. If there is more than one applicant, clicking the checkbox is intended as a representation to the Credit
Union that all such parties consent to these terms and conditions.
Specific Loan Application Disclosure Information
DISCLAIMER: I/WE HEREBY CERTIFY THAT ALL STATEMENTS MADE ARE TRUE AND COMPLETE, ARE SUBMITTED FOR THE PURPOSE OF OBTAINING CREDIT, AND THAT THE CREDIT UNION MAY RELY ON THEM FOR SUCH DETERMINATION. WE UNDERSTAND THAT FEDERAL LAW REQUIRES THE VERIFICATION OF IDENTIFICATION FOR ALL NEW ACCOUNTS SHOULD I NOT HAVE AN EXISTING ACCOUNT. I/WE AUTHORIZE YOU TO OBTAIN SUCH INFORMATION AS YOU MAY REQUIRE CONCERNING THE STATEMENTS MADE IN THIS APPLICATION AND PROPER IDENTIFICATION, AND AGREE THAT THE APPLICATION SHALL REMAIN YOUR PROPERTY, AND YOU ARE AUTHORIZED TO ANSWER QUESTIONS ABOUT YOUR CREDIT EXPERIENCE WITH ME/US.
I accept:
Security Code:
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Equal Housing LenderNational Credit Union Administration
NCUA - Your savings federally insured to at least $250,000 and backed by the full faith and credit of the United States Government. National Credit Union Administration, a U.S. Government agency. Equal Housing Lender - We do business in accordance with the Fair Housing Law and Equal Opportunity Credit Act