Amount / Credit Limit Requested:
Length of Repayment:
Length of Loan: ---YearsMonthsWeeksDays
Loan Type:* ---New AutoUsed AutoRefinanceLine of CreditPersonal LoanDebt ConsolidationMotorcycleRV / Boats / ATVs
Type of Credit: IndividualCo-applicant
Preferred Email:*
* = required
1: This is our joint application (both spouses sign) for credit as a debt of the marital community, based upon the creditworthiness of that community. (If this box is checked, supply all information required)2: This is my individual application for credit as a debt of the marital community, based upon the creditworthiness of that community. (If this box is checked, supply all information required.)3: This is an application for individual credit as my sole and separate debt. (Your application will be evaluated without regard to the assets, income or creditworthiness of your spouse or the marital community.) If this box is checked, give marital status and no other information regarding your spouse (if any) except name and address. List also all debts for which you are obligated by your signed promise to pay and list all your sole and separate assets and income.
Full Name:*
Birth date:*
Are you a member of Banner FCU?:* YesNo
If yes, what is your CU Account #:
Social Security #:*
Driver's License:
State:* ---ALAKAZARCACOCTDEFLGAHIIDILINIAKSKYLAMEMDMAMIMNMSMOMTNENVNHNJNMNYNCNDOHOKORPARISCSDTNTXUTVTVAWAWVWIWY
Marital Status SingleMarried
Number of Dependents:
Home/Cell Phone:*
Address*
City:*
Zip Code:*
How Many Years There? *
Own or Rent:* OwnRent
Preferred Contact Method:* PhoneEmail
Mortgage Company/ Rent Owed:*
Monthly Payment Amount:*
Employer:*
Phone:*
Job Title:*
Length of Time with Current Employer (in years):*
What is your gross annual income? *
Other Income: (Notice: Alimony,child support or separate maintenance income need not be revealed if you do not have it considered as a basis for repaying this obligation.)
Other income source:
What is your other annual income?
Please provide two references.
1.
Name:*
Address:*
2.
Birth Date:*
If yes, what is your CU Account #:*
Callback Number:*
Monthly Payment Amount: *
Mortgage Company / Rent Owed:
Monthly Payment Amount:
Employer:
Phone:
Job Title:
Length of Time with Current Employer (in years):
What is your gross annual income?
* You promise that everything you have stated in this request is correct to the best of your knowledge. If there are any important changes, you will notify us in writing immediately. You also agree to notify us of any change in your name, address or employment within a reasonable time thereafter. You authorize the credit union to obtain credit reports in connection with this request. 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. You understand that it is a federal crime to willfully and deliberately provide incomplete or incorrect information on requests made to Federal Credit Unions or State Chartered Credit Unions insured by the NCUA. You understand that the credit union will rely on the information in the request and your credit report to make its decision. By signing below, you agree to the terms of the loans Agreement and you agree to pay all charges incurred in accordance with the terms of that Agreement.
By submitting this loan request, you agree that the information is correct to the best of your knowledge.
