EZ APPLICATION

Phone: 504.728.4853
Fax to: 504.212.2150



* indicates a required field


*How did you hear about us?
Purpose of Loan
*Amount requested
Term requested
*Type of Credit
*Applicant
*Address
*City, State Zip ,
*Own or Rent      
Years at Address
Value of Current Home
*Monthly Payment
*Do you have a SBA Loan  
Monthly Payment
*Member Number
*Social Security Number
*Birth Date
Driver's License Number   State
*Phone
*E-mail
*Employer
*Start Date
*Position
*Work Phone
If Self Employed, Type of Business
*Gross Employment Income Per
*Employment Status
Other Income Per
Source
Notice: All income you wish the credit union to consider must be verifiable. Acceptable proof of income includes recent pay stubs, rental agreements or Federal tax returns in the case of self-employment. Alimony, Child Support, or Separate Maintenance Income need not be revealed if you do not choose to have it considered.

    *
*Applicant has one or more outstanding judgments  
*Applicant has filed chapter 7 bankruptcy or has a debt adjustment plan confirmed under chapter 13  
*Applicant had a foreclosure or repossession in the last 7 years  
*Applicant is a party to a lawsuit  
*Applicant is other than a U.S. citizen or permanent resident alien  
*Applicant's income is likely to decline in the next two years  
*Applicant has loans under names or Social Security numbers other than those listed on the application  
*Applicant is a co-maker, co-signer, or guarantor on any loans not at this credit union  
If "Yes", creditor's name

Complete for Joint Credit, Secure Credit or if you live in a Community Property State:




By filling out Co-Applicant section you certify you are applying for joint credit.

*Co-Applicant
*Address
*City, State Zip ,
Own or Rent      
Years at Address
Value of Current Home
Monthly Payment
Do you have a SBA Loan  
Monthly Payment
*Member Number
*Social Security Number
*Birth Date
Driver's License Number   State
*Phone
*E-mail
*Employer
*Start Date
*Position
*Work Phone
If Self Employed, Type of Business
*Gross Employment Income Per
*Employment Status
Other Income Per
Source
Notice: All income you wish the credit union to consider must be verifiable. Acceptable proof of income includes recent pay stubs, rental agreements or Federal tax returns in the case of self-employment. Alimony, Child Support, or Separate Maintenance Income need not be revealed if you do not choose to have it considered.

Complete for Joint Credit, Secure Credit or if you live in a Community Property State:

   

Applicant has one or more outstanding judgments  
Applicant has filed chapter 7 bankruptcy or has a debt adjustment plan confirmed under chapter 13  
Applicant had a foreclosure or repossession in the last 7 years  
Applicant is a party to a lawsuit  
Applicant is other than a U.S. citizen or permanent resident alien  
Applicant's income is likely to decline in the next two years  
Applicant has loans under names or Social Security numbers other than those listed on the application  
Applicant is a co-maker, co-signer, or guarantor on any loans not at this credit union  
If "Yes", creditor's name



*Reference: (1)
Address
City, State Zip ,
*Phone Number
Relationship
  Nearest relative not living with you
*Reference: (2)
Address
City, State Zip ,
*Phone Number
Relationship
  Nearest relative not living with you


Payment Protection Coverage

*Do you want your loan protected for you and your family if you become disabled?  
*Do you want your loan protected for you and your family in the event of your death?  

Date August 23, 2017

Comments or Special Instructions

By submitting this application, 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. 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 the NCUA.

If you are applying for a credit card, you understand that the use of your card will constitute acknowledgment of receipt and agreement to the terms of the credit card agreement and disclosures. In addition, your account is secured by all other shares and deposits you have in any individual or joint account with the credit union now and in the future, except for shares in an Individual Retirement Account or in any other account that would lose special tax treatment under state or federal law if given as security. You authorize the credit union to apply the balance in your individual or joint shares and deposits to pay any amounts due on your account if you should default.


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