LOAN APPLICATION
PLEASE PRINT THIS APPLICATION,  FILL IT OUT COMPLETELY AND MAIL OR FAX  IT TO:
TONAWANDA COMMUNITY FCU
257 HIGHLAND PARKWAY
BUFFALO NY 14223
Phone: (716) 873-4688    Fax: (716) 873-2124

APPLICANT FORM


If there is to be a CO-APPLICANT, SPOUSE or GUARANTOR on this loan they must print and fill out the OTHER FORM. Both the Applicant and Co-applicant must sign both forms.

MARRIED APPLICANTS MAY APPLY FOR A SEPARATE ACCOUNT. CHECK THE APPROPRIATE BOX TO INDICATE INDIVIDUAL CREDIT OR JOINT CREDIT.

I AM APPLYING FOR: qINDIVIDUAL CREDIT: PLEASE COMPLETE THIS ENTIRE FORM. 

COMPLETE THE CO-APPLICANT, SPOUSE, GUARANTOR REFERRED TO AS THE OTHER FORM:
1) ABOUT YOUR SPOUSE IF YOU LIVE IN A COMMUNITY PROPERTY STATE (AZ, CA, ID, LA, NM, NV, TX, WA, WI), OR 
2) IF YOUR SPOUSE WILL USE THE ACCOUNT, OR
3) IF THERE IS A GUARANTOR ON THIS ACCOUNT.

qJOINT CREDIT: PROVIDE INFORMATION ABOUT BOTH OF YOU BY COMPLETING THIS ENTIRE FORM AND THE OTHER FORM.

AMOUNT REQUESTED $ _________________  PURPOSE: __________________________________________________________________________

COLLATERAL: ________________________________________________________________________________________________________________

REPAYMENT: qPAYROLL DEDUCTION  qCASH  qAUTOMATIC PAYMENT  qMILITARY ALLOTMENT  q______________________


APPLICANT INFORMATION

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
HOME ADDRESS (STREET & NO.) ________________________________________________________________________ qOWN qRENT

CITY/STATE/ZIP ___________________________________________________________________   YEARS AT THIS ADDRESS _____________

PREVIOUS ADDRESS
HOME ADDRESS (STREET & NO.) ________________________________________________________________________ qOWN qRENT

CITY/STATE/ZIP ___________________________________________________________________   YEARS AT THIS ADDRESS _____________

COMPLETE FOR JOINT CREDIT, SECURED CREDIT OR IF YOU LIVE IN A COMMUNITY PROPERTY STATE
qMARRIED  qSEPERATED   qUNMARRIED  (SINGLE - DIVORCED - WIDOWED)
 

LIST AGES OF DEPENDENTS NOT LISTED BY OTHER APPLICANT
(EXCLUDE SELF) _________________________________________________________________________________________


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
NAME AND ADDRESS OF PREVIOUS EMPLOYER __________________________________________________________________________________

________________________________________________________________________________________________________________________________

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 _____________________________________________
 
 
LIST HOME & ALL OTHER ITEMS YOU OWN & LOCATION OF PROPERTY
FOR EXAMPLE: AUTO, BOAT, STOCKS, BONDS, CASH, REAL ESTATE, ETC
MARKET VALUE
PLEDGED AS COLLATERAL FOR ANOTHER LOAN
HOME
  $ qYES                qNO
    $ qYES                qNO
    $ qYES                qNO


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.

 
CREDITOR 
NAME & ADDRESS
ACCOUNT NUMBER
ORIGINAL BALANCE
PRESENT BALANCE
MONTHLY PAYMENT
CHECK IF PAST DUE 
qRENT
qMORGTAGE
    $ $ $  
      $ $ $  
      $ $ $  
      $ $ $  
      $ $ $  
      $ $ $  
      $ $ $  
      $ $ $  
      $ $ $  

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 _________


OFFICE USE ONLY: DO NOT WRITE IN THIS SPACE - FOR CREDIT UNION USE ONLY