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Loan Application

Loan Information
Applicant Information
Asset Information
Other Information
Disclosures and Signatures

* Indicates Required

  • Loan Information

    Application Type *
    Is your Co-Applicant your spouse?*
    Do you live in or is the property pledged as collateral located in a community property state (AK, AZ, CA, ID, LA, NM, NV, TX, WA, WI)*
    Will your spouse use the account?*
    Are you relying on your spouse's income as a basis for repayment?*
    Are you relying on income from alimony, child support, or separate maintenance as a basis for repayment?*
    Will this loan have a guarantor who is not your spouse or co-applicant?*
    Applicant and Co-Applicant each agree and acknowledge the intent to apply for joint credit (sign below):

    Payment Protection

    Are you interested in having your loan protected?*

    If you answer "yes", the credit union will disclose the cost to protect your loan. The protection is voluntary and does not affect your loan approval. In order for your loan to be covered, you will need to sign a separate application that explains the terms and conditions.

  • Applicant Information

    Present Address

    Last Previous Address:

    Additional Information

    Marital Status (Complete for Joint Credit, Secured Credit, or if you live in a community property state)

    Employment/Income

    Employment Status *

    If employed for less than 5 years at your current job:

    Additional Income

    Notice: Alimony, Child Support, or Separate Maintenance Income Need Not Be Revealed If You Do Not Choose To Have It Considered

    Military

    Is duty station transfer expected during next year?

    Reference

    Name and address of nearest relative not living with you

    Co-Applicant Information

    Type of Applicant

    Present Address

    Last Previous Address:

    Additional Information

    Marital Status (Complete for Joint Credit, Secured Credit, or if you live in a community property state)

    Employment/Income

    Employment Status *

    If employed for less than 5 years at your current job:

    Additional Income

    Notice: Alimony, Child Support, or Separate Maintenance Income Need Not Be Revealed If You Do Not Choose To Have It Considered

    Military

    Is duty station transfer expected during next year?

    Reference

    Name and address of nearest relative not living with you

    Spouse Information

    Type of Applicant

    Present Address

    Last Previous Address:

    Additional Information

    Marital Status (Complete for Joint Credit, Secured Credit, or if you live in a community property state)

    Employment/Income

    Employment Status *

    If employed for less than 5 years at your current job:

    Additional Income

    Notice: Alimony, Child Support, or Separate Maintenance Income Need Not Be Revealed If You Do Not Choose To Have It Considered

    Military

    Is duty station transfer expected during next year?

    Reference

    Name and address of nearest relative not living with you

    Guarantor/Other Information

    If you are relying on income from alimony, child support, or separate maintenance, complete this section to the extent possible about the person on whose payments you are relying.

    Type of Applicant

    Present Address

    Last Previous Address:

    Additional Information

    Marital Status (Complete for Joint Credit, Secured Credit, or if you live in a community property state)

    Employment/Income

    Employment Status *

    If employed for less than 5 years at your current job:

    Additional Income

    Notice: Alimony, Child Support, or Separate Maintenance Income Need Not Be Revealed If You Do Not Choose To Have It Considered

    Military

    Is duty station transfer expected during next year?

    Reference

    Name and address of nearest relative not living with you

  • What you Owe

    Debt 1

    Owed By

    Debt 2

    Owed By

    Debt 3

    Owed By

    Debt 4

    Owed By

    Debt 5

    Owed By

    Debt 6

    Owed By

    Debt 7

    Owed By

    Debt 8

    Owed By

    Debt 9

    Owed By

    Debt 10

    Owed By

    Debt 11

    Owed By

    Debt 12

    Owed By

    Totals

    What you Own

    Asset 1

    Pledged as collateral for another loan
    Owned By

    Asset 2

    Pledged as collateral for another loan
    Owned By

    Asset 3

    Pledged as collateral for another loan
    Owned By

    Asset 4

    Pledged as collateral for another loan
    Owned By

    Asset 5

    Pledged as collateral for another loan
    Owned By

    Asset 6

    Pledged as collateral for another loan
    Owned By

    Asset 7

    Pledged as collateral for another loan
    Owned By
  • Other Information About You (Applicant)

    Are you a U.S. Citizen or permanent resident alien? *
    Do you have any outstanding judgments or have you ever filed for bankruptcy, had a debt adjustment plan confirmed under chapter 13, had property foreclosed upon or repossessed in the last 7 years, or been a party in a lawsuit? *
    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? *

    Other Information About You (Co-Applicant)

    Are you a U.S. Citizen or permanent resident alien? *
    Do you have any outstanding judgments or have you ever filed for bankruptcy, had a debt adjustment plan confirmed under chapter 13, had property foreclosed upon or repossessed in the last 7 years, or been a party in a lawsuit? *
    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? *

    Other Information About You (Spouse)

    Are you a U.S. Citizen or permanent resident alien? *
    Do you have any outstanding judgments or have you ever filed for bankruptcy, had a debt adjustment plan confirmed under chapter 13, had property foreclosed upon or repossessed in the last 7 years, or been a party in a lawsuit? *
    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? *

    Other Information About You (Guarantor/Other)

    Are you a U.S. Citizen or permanent resident alien? *
    Do you have any outstanding judgments or have you ever filed for bankruptcy, had a debt adjustment plan confirmed under chapter 13, had property foreclosed upon or repossessed in the last 7 years, or been a party in a lawsuit? *
    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? *
  • Consent to Contact

    By executing this application, you agree we and/or our third party providers, including debt collectors, may contact you by telephone or text message at any telephone number associated with your account, including wireless telephone numbers (i.e. cell phone numbers) which could result to charges to you, in order to service your account or collect any amounts owed to us, excluding any contacts for advertising or telemarketing purposes as prescribed by law. You further agree methods of contact may include use of pre-recorded or artificial voice messages, and/or use of an automatic dialing device. You may withdraw consent to be contacted on your wireless telephone number(s) at any time by written notice to us at 506 W. Fairchild Street, Danville IL 61832, via phone at 217-442-9005 or 1-800-533-5615 or by any other reasonable means. If you have provided a wireless telephone number(s) on or in connection with any account, you represent and agree you are the wireless subscriber or customary user with respect to the wireless telephone number(s) provided and have the authority to give this consent. Furthermore, you agree to notify us of any change to the wireless telephone number(s) which you have provided to us.

    State Law Notice(s)

    Notice to Nebraska Residents

    A credit agreement must be in writing to be enforceable under Nebraska law. To protect you and us from any misunderstandings or disappointments, any contract, promise, undertaking, or offer to forebear repayment of money or to make any other financial accommodation in connection with this loan of money or grant or extension of credit, or any amendment of, cancellation of, waiver of, or substitution for any or all of the terms or provisions of any instrument or document executed in connection with this loan of money or grant or extension of credit, must be in writing to be effective.

    Notice to New York Residents

    New York residents may contact the New York State Department of Financial Services to obtain a comparative listing of credit card rates, fees, and grace periods. New York State Department of Financial Services: 1-800-342-3736 or www.dfs.ny.gov.

    Notice to Ohio Residents

    The Ohio laws against discrimination require that all creditors make credit equally available to all creditworthy customers, and that credit reporting agencies maintain separate credit histories on each individual upon request. The Ohio Civil Rights Commission administers compliance with this law.

    Notice to Wisconsin Residents

    (1) No provision of any marital property agreement, unilateral statement under section 766.59, or court decree under section 766.70 will adversely affect the rights of the Credit Union unless the Credit Union is furnished a copy of the agreement, statement, or decree, or has actual knowledge of its terms, before the credit is granted or the account is opened. (2) Please sign if you are not applying for this account or loan with your spouse. The credit being applied for, if granted, will be incurred in the interest of the marriage or family of the undersigned.

    Signatures

    By signing or otherwise authenticating below:

    1. You 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 what you owe. 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 recieved. You understand that the credit Union will tell you the name and address of any credit bureau from which it recieved a credit report on you. It is a crime to willfully and deliberately provide incomplete or incorrect information on this application.