Online Loan Application

APPLICATION FORM

General Information

Amount: $ Purpose of Loan:
Security Offered:
Applicant Information
Member #:
If you are not a member, how did you find out about our credit union?:
First Name: Middle Initial:
Last Name:
Driver's License #:
Date of Birth (dd/mm/yyyy):      /   / 
Marital Status: Tel #:
How many dependents:
 
Co-Applicant Information
 
Member #:
First Name: Middle Initial:
Last Name:
Driver's License #:
Date of Birth (dd/mm/yyyy):  /   / 
Marital Status #: Tel #:
Home Address
No.
Street:
City/Town:
Province: Postal Code:
Length of Time at Current Address: Land Lord:
Previous Address
No.
Street:
City/Town:
Province: Postal Code:
Length of Time at Prev Address: Land Lord:
 
Applicant Employment Information
 
Current Employer:
How Long?: yrs.   mos.
Company Name:
Address:
Tel. #:
Occupation:
Annual Gross: $ Pay Frequency:
Previous Employer (if less than 3yrs w/ current):
 
How Long?: yrs.   mos.
Company Name:
Other Income (Source & Amount):
 
Spouse / Co-Applicants Employment Information
 
Current Employer:
How Long?: yrs.   mos.
Company Name:
Address: Tel. #:
Occupation:
Annual Gross: $ Pay Frequency:
Previous Employer (if less than 2yrs w/ current):
 
How Long?: yrs.   mos.
Company Name:
Other Income (Source & Amount):
 
Personal Statement of Net Worth
N.B. Joint Statement of husband and wife to be supported by acceptable financial statements and income tax returns if required.
 
Assets
Real Estate: $
Investments - Stocks, Bonds: $
Vehicle1 - Depreciated Value: $        Make:   Model:   Year:
Vehicle2 - Depreciated Value: $        Make:   Model:   Year:
Household and Personal Effects: $
Chequing Account(s): $
Financial institution:
Savings and Certificates: $
Financial institution:
R.R.S.P.: $
Financial institution:
Other Assets Value($) and Description:
Liabilities
Mortgage monthly payment: $   Mortgage balance:
Financial Institution:
Mortgage / Rent monthly payment: $
Financial Institution:
Loan balance: $   Monthly payment:
Financial institution:
Credit Cards Balance: $   Monthly payment:
Financial Institution:
Child Support / Alimony monthly Payment : $
Heat monthly payment: $
Description:
Condo Fee monthly payment: $
Description:
Rent /Taxes monthly payment: $
Description:
Other monthly payment: $   
Description:
Personal References
Reference One:
Name: Occupation:
Address: City:
Postal Code: Tel.#:
Relation:
Reference Two:
Name: Occupation:
Address: City:
Postal Code: Tel.#:
Relation:
Additional Info You Wish To Add:
Upload Attachment:

Contact Telephone No.
Please enter your e-mail address:
Please read and check:
 I / We hereby acknowledge notice from the Credit Union that a consumer report containing credit information is being or may be referred to in connection with the credit hereby applied for any renewal or extension thereof.
Enter the text shown in the image below:
Security Image
(case insensitive)

Show another image