Jessop FCU Loan Application - Jessop Community FCU

Loan Information

Check below to indicate the type of account(s) and type of loan for which you are applying. Married Applicants may apply for a separate account.

Loan Application Account *

Individual Joint (Including ATM/Debit Card Access to the Account if Available)

Loan Amount *

Loan Purpose & Collateral *

Repayment Option *

Automatic Deduction Payroll Deduction Cash Military Allotment

Are you interest in having your loan protected? *

Yes No

If you answer "yes", the credit union will disclose the cost to protect your loan. The protection is voluntary and does not affect your loan approval. In order for your loan to be covered, you will need to sign a separate application that explains the terms and conditions.

Primary Applicant

Jessop Community FCU Account Number *

First Name *

MI

Last Name *

Date of Birth *

SSN *

Driver's License State/No. *

Email *

Home Phone

Mobile Phone

Work Phone

Marital Status

Complete for joint credit, secured credit, or if you live in a community property state.

N/A Married Separated Unmarried (Single, Divorced, Widowed)

Current Residence

Address *

City *

State *

Zip Code *

Do you own or rent? *

Own Rent

Length at Residence *

Previous Residence (If less than five (5) years ago)

Address

City

State

Zip Code

Did you own or rent?

Own Rent

Length at Residence

Income

Employer

Address

City

State

Zip Code

Job Title

Supervisor

Start Date

Hours per Week

Income

per

Gross or net

Gross Net

Reference

Nearest relative not living with you *

Relationship *

Address *

City *

State *

Zip Code *

Phone

Joint Applicant

First Name *

MI

Last Name *

Date of Birth *

SSN *

Driver's License State/No. *

Email

Home Phone

Mobile Phone

Work Phone

Marital Status

Complete for joint credit, secured credit, or if you live in a community property state.

N/A Married Separated Unmarried (Single, Divorced, Widowed)

Current Residence

Copy primary applicant address

Address *

City *

State *

Zip Code *

Do you own or rent? *

Own Rent

Length at Residence *

Previous Residence (If less than five (5) years ago)

Copy primary applicant address

Address

City

State

Zip Code

Did you own or rent?

Own Rent

Length at Residence

Income

Employer

Address

City

State

Zip Code

Job Title

Supervisor

Start Date

Hours per Week

Income

per

Gross or net

Gross Net

Reference

Nearest relative not living with you *

Relationship *

Address *

City *

State *

Zip Code *

Phone

Current Debts

Debt

Monthly Payment

Signature(s)

You 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 what you owe. If there are any important changes, you will notify us in writing immediately. You authorize the Credit Union to obtain credit reports in connection with this application for credit and for any update, increase, renewal, extension, or collection of the credit received. You understand that the Credit Union will rely on the information in this application and your credit report to make its decision. If you request, the Credit Union will tell you the name and address of any credit bureau from which it received a credit report on you. 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.

Typing your name(s) into the signature field(s) below will constitute an electronic signature.

Primary Applicant Signature *

Date *