Beaver Valley Federal Credit Union

MEMBER WITH BORROWING PRIVILEGE MAY,
IF MARRIED, APPLY FOR A SEPARATE ACCOUNT.

If you are relying on your salary and that of your spouse, alimony, child support or maintenance payments, then you must complete all of the information requested below. But if you are applying for credit in your name alone, are not married, not relying on alimony, child support or maintenance payments as a basis for repayment of the credit requested, you need not include any information about your spouse or co-applicant.

I am applying for credit:
In my name alone Jointly with my spouse With another person

LOAN INFORMATION
Account Number:
 Amount Requested:
 Purpose of Loan:
Type of Loan:
 Method of Payment:
Cash Direct Deposit Payroll Deduction (if eligible)
PERSONAL INFORMATION
Full Name: (Last, First, Middle)
 Date of Birth:
 Social Security Number:
 Married
Separated
Unmarried
Home Address: (Street, City, State, Zip)
 How long:
 Home Phone:
 No. Dependants: (excludes yourself)
Spouse or Co-Applicant's Name (and address if different from above)
 Date of Birth:
 Social Security Number:
Name of nearest relative not living with you
 Address:
Relationship
 Phone Number with area code
Have you or your co-applicant ever been granted credit under any other name(s): yes no
If "Yes" list names:
Name:
 Name:
 Name:
EMPLOYMENT AND INCOME
Gross Salary:
$ 		Weekly Biweekly
Monthly		 Employer Name & Address:
Phone:
 Date Hired:
 Position:
Spouse or Co-App's Gross Salary:
$ 		Weekly Biweekly
Monthly		 Employer Name & Address:
Phone:
 Date Hired:
 Position:
Retirement or other*:
$ 		Monthly
Other		 List sources of other income:
 *Note: Income from alimony, child support or spouse support need not be stated unless you want BVFCU to consider for loan purposes.
Your last three pay stubs will be
required to verify income.		 Best time to call home:
 Best time to call work:
DEPOSIT ACCOUNTS AND FINANCIAL OBLIGATIONS
Please include accounts and obligations of your listed spouse or co-applicant in addition to your own and designate which are yours with and asterisk (*). Please list the financial institution where you have your primary savings and checking accounts.
Savings Financial Institution:
 Address:
 Balance:
$
Checking Financial Institution:
 Address:
 Balance:
$
Home Mortgage Financed By:
 Monthly Payment or Rent:
$ 		Balance Owing:
$
Other Mortgage Holder:
 Monthly Payment or Rent:
$ 		Balance Owing:
$
Have YOU or your Spouse or Co-Applicant ever:
  • Been Sued?
Yes No Year:
  • Filed Bankruptcy?
Yes No Year:
  • Filed Chapter 13 Bankruptcy?
Yes No Year:
Value of Home:
$ 		Monthly Child Care:
$ 		Monthly Alimony, Child Support:
$
Auto Make:
 Auto Model:
 Auto Year:
 Buying
Own
Auto Make:
 Auto Model:
 Auto Year:
 Buying
Own
Name of Creditors (including BVFCU) Complete Address
  Original Amount Present Balance Monthly Payment
  $ $ $
  $ $ $
  $ $ $
  $ $ $
  $ $ $
  $ $ $
  $ $ $
YOU MUST LIST ALL YOUR DEBTS- Attach page if necessary Totals: $ $

I/We hereby certify that all statements made (including those attached) are true and complete and submitted for the purpose of obtaining credit. I/We have no other debts. I/We understand that you will retain this application whether or not it is approved. You are authorized to check my/our credit and employment history and to answer questions about your credit experience with me/us.

Please include: Credit Life Insurance Credit Disability Insurance Joint Credit Life Insurance
X________________________________
Applicant's Signature		 X_______________________
Date
X________________________________
Spouse or Co-Applicant's Signature		 X_______________________
Date

 

OFFICE USE ONLY

  
Application received on:_____________________________
APPROVED DENIED by:_____________________ Date:__________________

THANK YOU FOR USING YOUR CREDIT UNION

 

 
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