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Purpose of loan
Amount Requesting

Loan to be repaid in months or at $ per pay/month

What are you offering as collateral (if any) on this loan?

Would  you like your loan payments made through Payroll Deduction? 
yes      no
Type of Credit
Individual   Joint

Account Number
Name
Social Security Number
Marital Status
Date of Birth
Current Loan Balance
(If this Loan Request is to Refinance a loan you currently have)
Real Estate Owned
Vehicle Owned

Debt Protection
Debt Protection is voluntary and not a requirement of your loan.

To be eligible to apply, I must meet the following conditions: (1) I am under age 70; (2) if applying for Death or Disability protection: During the last 2 years, I have not been advised or treated for: cancer, heart attact or coronary artery disease, stroke, cirrhosis, AIDS, or any disorder of my immune system, or had any test showing evidence of antibodies to the AIDS virus (a positive HIV test); (3) if applying for Disability protection: I am presently working twenty-four (24) or more hours per week; and (4) if applying for Involuntary Unemployment protection: I am not self-employed, and I have not received unemployment benefits within the past 2 years.

Assuming your application for credit is approved and you are eligible for Debt Protection, the Credit Union will disclose its total cost to you. You will also be asked to sign the request for coverage, Loan Note, Security Agreement and Truth-In-Lending Disclosure form.

Indicate which credit insurance option(s) you desire:

Would you like Life, Disability, and Involuntary Unemployment protection?
yes     no

Would you like Life and Disability protection only?
yes     no

Would you like Life protection only?
yes     no

Address, if RD# provide brief description of location:

How long have you been at this residence?
Years     Months
Rent     Own Monthly Payment
If Owned, Present Market Value

Home Phone #
Work Phone #
Other Phone # (i.e. page, cell)
E-mail Address

Your Employer

Employer's address

Occupation
Department
Length of Employment
Gross Income
per
hour     week     month
# of hours worked per week

Other income
per
hour     week     month
Source

*** The Credit Union may require PROOF OF INCOME***

Nearest relative not living with you?
Relationship
Relative's Home Phone Number

Their address

Personal Reference
Relationship
Reference's Home Phone Number

Their address

Outstanding Debt
Payment Type Monthly Payment Balance Owed
Home Equity
Home Equity
Auto Loan
Auto Loan
Credit Card
Credit Card
Credit Card
Credit Card
Credit Card
Credit Card
Credit Card
Credit Card
Child Support
Other

If requesting joint credit:

Co-Borrower's Information

Account #
Name
Social Security Number
Current Loan Balance
Real Estate Owned
Vehicle Owned

Debt Protection
Debt Protection is voluntary and not a requirement of your loan.

To be eligible to apply, I must meet the following conditions: (1) I am under age 70; (2) if applying for Death or Disability protection: During the last 2 years, I have not been advised or treated for: cancer, heart attact or coronary artery disease, stroke, cirrhosis, AIDS, or any disorder of my immune system, or had any test showing evidence of antibodies to the AIDS virus (a positive HIV test); (3) if applying for Disability protection: I am presently working twenty-four (24) or more hours per week; and (4) if applying for Involuntary Unemployment protection: I am not self-employed, and I have not received unemployment benefits within the past 2 years.

Assuming your application for credit is approved and you are eligible for Debt Protection, the Credit Union will disclose its total cost to you. You will also be asked to sign the request for coverage, Loan Note, Security Agreement and Truth-In-Lending Disclosure form.

Indicate which credit insurance option(s) you desire:

Would you like Life, Disability, and Involuntary Unemployment protection?
yes     no

Would you like Life and Disability protection only?
yes     no

Would you like Life protection only?
yes     no

Address, if RD# provide brief description of location:

How long have you been at this residence?
Years     Months
Rent     Own Monthly Payment
If Owned, Present Market Value

Home Phone #
Work Phone #
Other Phone # (i.e. page, cell)
E-mail Address

Your Employer

Employer's address

Occupation
Department
Length of Employment
Gross Income
per
hour     week     month
# of hours worked per week

Other income
per
hour     week     month
Source


*** The Credit Union may require PROOF OF INCOME***

Nearest relative not living with you?
Relationship
Relative's Home Phone Number

Their address 

Personal Reference
Relationship
Reference's Home Phone Number

Their address

Outstanding Debt
Payment Type Monthly Payment Balance Owed
Home Equity
Home Equity
Auto Loan
Auto Loan
Credit Card
Credit Card
Credit Card
Credit Card
Child Support
Other

You authorize the credit union to check your employment and credit history and to obtain credit reports in connection with this application for credit and for any update, renewal or extension of the credit received.

"You 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 Credit Union to obtain credit reports in connection with this application for credit and for any update, increase, renewal, extension, or collection of the credit received. You understand that the 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. If you provide us with a co-applicant on this loan, you are also agreeing that the co-applicant has authorized submission of this application and agrees to these terms. 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".

Click the "submit" button below to submit your online loan application. (By submitting your application, you acknowledge understanding of the above and wish to continue the processing of this application.)

Thank you for applying for a loan with Monad Federal Credit Union!