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(OTHER FORM) PLEASE PRINT THIS APPLICATION, FILL IT OUT COMPLETELY AND MAIL OR FAX THIS FORM AND THE APPLICANT FORM TO: TONAWANDA COMMUNITY FCU 257 HIGHLAND PARKWAY BUFFALO NY 14223 Phone: (716) 873-4688 Fax: (716) 873-2124 OTHER FORM: To be used by CO-APPLICANT,
SPOUSE,
GUARANTOR
If there is to be a CO-APPLICANT, SPOUSE or GUARANTOR on this loan they must print and fill out this form. The Loan Applicant must print and fill out the Applicant Form as well. Both the Applicant and Co-applicant must sign both forms. I AM APPLYING FOR JOINT CREDIT AS: qCO-APPLICANT qSPOUSE qGUARANTOR PROVIDE INFORMATION ABOUT BOTH OF YOU BY COMPLETING THIS ENTIRE FORM AND THE APPLICANT FORM. AMOUNT REQUESTED $ _________________ PURPOSE: __________________________________________________________________________ COLLATERAL: ________________________________________________________________________________________________________________ REPAYMENT: qPAYROLL
DEDUCTION qCASH qAUTOMATIC
PAYMENT qMILITARY ALLOTMENT q______________________
CO-APPLICANT, SPOUSE or GUARANTOR INFORMATION CO-APPLICANT NAME (Last) __________________________________________ (First) ________________________________________ (MI) ___________ DRIVER LICENSE NUMBER / STATE ____________________________________________________________ Date of Birth _____________________ MEMBER ACCOUNT # ___________________________________ SOCIAL SECURITY # __________________________________________________ DAY TIME PHONE NUMBER:_____________________________ EVENING PHONE NUMBER:__________________________________ PRESENT ADDRESS
CITY/STATE/ZIP ___________________________________________________________________ YEARS AT THIS ADDRESS _____________ PREVIOUS ADDRESS
CITY/STATE/ZIP ___________________________________________________________________ YEARS AT THIS ADDRESS _____________ COMPLETE FOR JOINT CREDIT, SECURED CREDIT OR IF YOU LIVE
IN A COMMUNITY PROPERTY STATE
LIST AGES OF DEPENDENTS
NOT LISTED BY APPLICANT
EMPLOYMENT INFORMATION NAME AND ADDRESS OF EMPLOYER _____________________________________________________________________________________________ ________________________________________________________________________________________________________________________________
YOUR TITLE / GRADE __________________________________________________________________________________ SUPERVISOR'S NAME ______________________________________________________ PHONE ___________________________ START DATE ______________________ HOURS AT WORK ______________________ IF SELF EMPLOYED, TYPE OF BUSINESS _______________________________________________________________________ COMPLETE IF EMPLOYED IN CURRENT POSITION LESS THAN 5 YEARS
________________________________________________________________________________________________________________________________ START DATE ______________________ ENDING DATE ______________________ MILITARY IS DUTY STATION TRANSFER EXPECTED DURING
THE NEXT YEAR? qYES qNO
SEPARATION DATE _________________
REFERENCES PLEASE INCLUDE STREET, CITY, STATE AND ZIP NAME & ADDRESS OF CREDITOR(S) OF DEBTS PAID OFF: _____________________________________________________________________________________ PHONE ___________________________ _____________________________________________________________________________________ PHONE ___________________________ _____________________________________________________________________________________ PHONE ___________________________ NAME & ADDRESS OF NEAREST RELATIVE NOT LIVING WITH YOU: _________________________________________________________RELATIONSHIP__________________________ PHONE _______________ NAME & ADDRESS OF PERSONAL FRIEND - NOT A RELATIVE: _____________________________________________________________________________________ PHONE ___________________________
INCOME INFORMATION YOU ARE NOT REQUIRED TO DISCLOSE INCOME FROM ALIMONY, CHILD SUPPORT OR SEPARATE MAINTENANCE UNLESS YOU WANT IT CONSIDERED IN CONNECTION WITH THIS APPLICATION. EMPLOYMENT INCOME $ ________________________ PER ___________________ qNET qGROSS OTHER INCOME $ ________________________ PER
___________________ SOURCE _____________________________
ASSETS: LIST ALL ASSETS AND ACCOUNT NUMBER(S) - ATTACH OTHER SHEETS IF NECESSARY. SHARE DRAFT OR CHECKING AMT $______________ NAME/ADDRESS OF DEPOSITORY _____________________________________________ SAVINGS AMOUNT $____________________________ NAME/ADDRESS
OF DEPOSITORY _____________________________________________
DEBTS: IN ADDITION TO RENT/MORTGAGE LIST ALL OTHER DEBTS (FOR EXAMPLE: AUTO LOANS, CREDIT CARDS, SECOND MORTGAGES, HOME ASSOC. DUES, ALIMONY, CHILD SUPPORT, CHILD CARE, MEDICAL, UTILITIES, AUTO INSURANCE, IRS LIABILITIES, ETC.) PLEASE USE A SEPARATE LINE FOR EACH CREDIT CARD AND AUTO LOAN - ATTACH OTHER SHEETS IF NECESSARY.
LIST ANY NAMES UNDER WHICH YOUR CREDIT REFERENCES AND
CREDIT HISTORY CAN BE CHECKED:
FINANCIAL INFORMATION IF A "YES" ANSWER IS GIVEN TO A QUESTION, EXPLAIN ON AN ATTACHED SHEET. DO YOU HAVE ANY OUTSTANDING JUDGMENTS? qYES qNO HAVE YOU EVER FILED FOR BANKRUPTCY OR HAD A DEBT ADJUSTMENT PLAN CONFIRMED UNDER CHAPTER 13? qYES qNO HAVE YOU HAD PROPERTY FORECLOSED UPON OR REPOSSESSED IN THE LAST 7 YEARS? qYES qNO ARE YOU A PARTY IN A LAW SUIT? qYES qNO ARE YOU OTHER THAN A US CITIZEN OR PERMANENT RESIDENT ALIEN? qYES qNO IS YOUR INCOME LIKELY TO DECLINE IN THE NEXT 2 YEARS? qYES qNO ARE YOU A CO-MAKER, CO-SIGNER OR GUARANTOR ON ANY LOAN NOT LISTED ABOVE? qYES qNO FOR WHOM (NAME OF OTHERS OBLIGATED ON LOAN) ___________________________________________ TO WHOM (NAME OF CREDITOR) _______________________________________________________________
SIGNATURES: 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 also 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 all your debts and obligations. You authorize The Tonawanda Community Federal Credit Union to obtain credit reports in connection with this application for credit and for any update, renewal or extension of the credit received. If you request, The Tonawanda Community Federal 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 loan applications made to Federal Credit Unions or State Chartered Credit Unions insured by NCUA. Applicant Signature ___________________________________________________
Date _________
Co-applicant Signature _________________________________________________ Date _________
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