Loan Application



Instructions:

If you are a member of this credit union, complete the loan application below and press the Submit button to send your application for processing.

If you are NOT a member, please check the Membership Requirements prior to completing the Loan Application.

For the purpose of confidentiality, you may want to print a hardcopy of this application and either mail or fax it to the Valley Federal Credit Union.

PLEASE PROVIDE ALL OF THE INFORMATION REQUESTED BELOW. Incomplete applications may delay processing.

All stated income will be subject to verification.



LOAN INFORMATION

TYPE OF LOAN

If other, specify:


LOAN AMOUNT


NUMBER OF MONTHS



APPLICANT INFORMATION
Name Account Number
Social Security Number Birthdate
Address
City State Zip Code
Number of years at address
Telephone Numbers:
Home Work
Number of Dependents (Include ages)
Name of Checking Account Institution

Type of Housing:

Mortgagee/Landlord Name
Monthly Payment
Employer Name Date of Hire
Previous Employer
From To



CO-APPLICANT INFORMATION
Account Number (If applicable)
Name
Social Security Number
Address (If different from borrower)
City State Zip Code
Telephone Numbers:
Home Work
Number of Dependents (Include ages)
Name of Checking Account Institution
Employer Name Hire Date



MONTHLY GROSS INCOME

Additional income need not be mentioned if you do not wish to use it as a basis for qualification.

Gross Income:
Borrower Co-Applicant
Other Income: (i.e. rental property, social security, pension, etc.)
Borrower Co-Applicant



Are you obligated to pay child support, alimony, or other maintenance?

Applicant If yes, amount $ per
Co-Applicant If yes, amount $ per



CREDIT INSURANCE

STATEMENT OF INTENT

Check coverage(s) desired. The credit union will disclose the cost of this voluntary insurance to you. A separate insurance election which discloses the terms and conditions must be signed for coverage to become effective.

Check if desired

Single Credit Disability Insurance
Joint Credit Disability Insurance
Single Credit Life Insurance
Joint Credit Life Insurance
I elect to decline any type of loan insurance.



BY FILLING OUT THIS APPLICATION YOU AGREE TO THE FOLLOWING:
Everything you have stated in this application is correct. You agree that we may obtain and use consumer credit reports and exchange credit and employment information in connection with this application and any update, renewal, or extension of credit we may extend to you. You agree that your account will be subject to the terms and conditions of all applicable Loan Agreements and Disclosure Statements. You agree that a photocopy or facsimile of this application shall be as binding as the original. You understand that we will retain this application whether or not it is approved.

All submitted appilcations are subject to "Valley Federal Credit Loan Underwriting Guidelines.



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