Valley Community CU WWW Text Loan Application 123 McClure Ave Nampa, ID. 83606 PLEASE PRINT THIS APPLICATION, COMPLETE IT, AND MAIL IT TO US. IF YOU DO NOT WANT US TO CONTACT YOU VIA EMAIL, PLEASE LEAVE YOUR EMAIL ADDRESS BLANK. IF ADDITIONAL INFORMATION IS NECESSARY, WILL CONTACT YOU VIA TELEPHONE, MAIL OR EMAIL (IF APPLICABLE). YOU MAY CONTACT US AT ANY TIME TO CHECK THE STATUS OF THIS REQUEST. Purpose of Loan ____________________________________________________ Amount Requested $_____________________ Term in Months _____________ ++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++ Credit Insurance is not required for loan approval but is available for purchase for your protection. Please select insurance coverages desired. None____ Single Credit Life Only ____ Joint Credit Life ____ Disability Insurance only ____ Disability Insurance with: Single Life ______ Joint Life ____ +++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++ PRINCIPAL APPLICANT INFORMATION: Name (First, Initial, Last) ________________________________________ Account No. ___________ Social Security No. ________________________ Date of Birth _______ Home Phone ______________ Day Phone __________ Street Address __________________________ City, State ______________ Zip _________ Circle One---> Own - Buying - Rent - Live with Others Email Address ______________________________________________________ Employer __________________________________ Hire Date ______________ Employer's Address _________________________________________________ Your Position _____________________ Gross Monthly Income $ _________ If less than 3 years with current employer, please complete: Previous Employer _________________________ Hire Date ______________ Your Position _____________________ Name of friend or relitive (not living with you) Name ___________________________________________ Address ________________________________________ Phone ________________________ Complete the following only if you live in a community property state. (AZ, CA, ID, LA, NV, NM, TX, WA, WI) Married _______ Unmarried _________ Seperated _________ Note: Alimony, child support or separate maintenance payments need not be disclosed unless you want us to consider such income in connection with this loan application. Other Income $______________ Source ____________________________________ Are You a co-maker on other loans ______ If yes, Amount$ ____________ Do you have any judgments against you ________ If yes, Amount$ ____________ Owed to whom ________________________________ Have you have ever filed bankruptcy --- If yes, Year _____________ Please List All Debts: Purpose Creditor Balance Owed Monthly Pmt -------------------------------------------------------------------- Housing | | | | | | Auto | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | -------------------------------------------------------------------- ++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++ CO-APPLICANT INFORMATION (if applicable): Name (First, Initial, Last) ________________________________________ Account No. ___________ Social Security No. ________________________ Date of Birth _______ Home Phone ______________ Day Phone __________ Street Address __________________________ City, State ______________ Zip _________ Circle One---> Own - Buying - Rent - Live with Others Email Address ______________________________________________________ Employer __________________________________ Hire Date ______________ Employer's Address _________________________________________________ Your Position _____________________ Gross Monthly Income $ _________ If less than 3 years with current employer, please complete: Previous Employer _________________________ Hire Date ______________ Your Position _____________________ Name of friend or relitive (not living with you) Name ___________________________________________ Address ________________________________________ Phone ________________________ Complete the following only if you live in a community property state. (AZ, CA, ID, LA, NV, NM, TX, WA, WI) Married _______ Unmarried _________ Seperated _________ Note: Alimony, child support or separate maintenance payments need not be disclosed unless you want us to consider such income in connection with this loan application. Other Income $______________ Source ____________________________________ Are You a co-maker on other loans ______ If yes, Amount$ ____________ Do you have any judgments against you ________ If yes, Amount$ ____________ Owed to whom ________________________________ Have you have ever filed bankruptcy --- If yes, Year _____________ Please List All Debts: Purpose Creditor Balance Owed Monthly Pmt -------------------------------------------------------------------- Housing | | | | | | Auto | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | -------------------------------------------------------------------- I understand that the credit union may obtain a credit report and answer questions from other creditors regarding my credit performance on this, or any other credit obligation with the credit union. This information is submitted for the purpose of obtaining credit. Applicant Signature ____________________________________ Date ________________ Co-Applicant Signature ____________________________________ Date ________________