Loan Application

LOAN APPLICATION

NOTICE: Married applicants may apply for separate accounts. Check the box indicating the type of credit your are applying for: Individual Credit: 1)Complete applicant section if you are relying only on your own income and assets to establish credit. 2)Complete other applicant section providing information about your spouse or former spouse if you reside in a community property state (AZ, CA, ID, LA, NM, NV, TX, WA, WI) or if you are relying on alimony, child support or separate maintenance payments to establish credit. Joint Credit: 1)Complete applicant and co-applicant section providing information about you and the other party.

Amount Requested Purpose:

Collateral:

Applicant

Co-Applicant Spouse Guarantor

Name:		Name:
Driver's License Number/State:		Driver's License Number/State:
Account Number:		Account Number:
Social Security #:		Social Security #:
Birth Date:		Birth Date:
Home Phone: E-mail Address: Business Phone/Ext.:		Home Phone: Business Phone/Ext.:
Present Address: Years There: Own Rent		Present Address: Years There: Own Rent
Last Previous Address: Years There: Own Rent		Last Previous Address: Years There: Own Rent
Complete for Joint Credit, Secured Credit or if you live in a Community Property State: Married Separated Unmarried (Single - Divorced - Widowed)		Complete for Joint Credit, Secured Credit or if you live in a Community Property State: Married Separated Unmarried (Single - Divorced - Widowed)
Number of Dependents other than listed by Co-Applicant (exclude self)	Ages	Number of Dependents other than listed by Co-Applicant (exclude self)	Ages

EMPLOYMENT AND INCOME INFORMATION
Name and Address of Employer:	Name and Address of Employer:
Position	Position
Supervisor	Supervisor

Start Date Self Employed Yes No	Start Date Self Employed Yes No
Military: Is duty station transfer expected during next 12 months Yes NO	Military: Is duty station transfer expected during next 12 months Yes NO
NOTICE: Alimony, child support, or separate maintenance income need not be revealed if you do not choose to have it considered.	NOTICE: Alimony, child support, or separate maintenance income need not be revealed if you do not choose to have it considered.
Employment Income: Net Gross $ PER Other Income: $ PER Source	Employment Income: Net Gross $ PER Other Income: $ PER Source
If employed in current position less than five years, complete the following:	If employed in current position less than five years, complete the following:

Previous employer name & address Starting Date Ending Date	Previous employer name & address Starting Date Ending Date
Position	Position
Supervisor	Supervisor

THESE QUESTIONS APPLY TO BOTH APPLICANT & CO-APPLICANT
If a "YES" answer is given to a question, explain on an attached sheet
	Applicant		Co-Applicant
	Yes	No	Yes	No
Have you any outstanding judgments against you?
In the last 10 years, have you filed a petition for relief under the bankruptcy code?
Have you had property foreclosed upon or given title or deed in lieu thereof, in the last 7 years?
Are you a party in a law suit?
Are you other than a U.S. Citizen or Permanent Resident Alien?
Is your income likely to be reduced in the near future?
Are you a co-signer/guarantor on any loan? If yes, answer next two questions.
For whom (name of others obligated on loan):
To whom (name of creditor):

Name and Address of nearest Relative not living with you Relationship Home Phone	Name and Address of nearest Relative not living with you Relationship Home Phone
Name and Address of personal friend - not living with you Home Phone	Name and Address of personal friend - not living with you Home Phone

ASSETS
A= Applicant C= Co-Applicant		Name of Depository	Address	Balance
A C	Checking Account(s)
A C	Savings Account(s)
A C	Certificate of Deposit(s)
A C	IRA
A C	Annuities
A C	Stocks/Bonds
A C	Life Insurance
A C	Other
A C	Other
A C	Other
A C	Other
A C	Auto(s) Owned	Make	Model	Year
A C	Auto(s) Owned	Make	Model	Year

OUTSTANDING DEBTS (List everything, attach other sheets if necessary)
A = Applicant C = Co-Applicant		Creditor Name & Address	Account Number	Present Balance	Monthly Payment	Past Due
A C	Rent
A C	Home Mortgage
A C	Second Mortgage
A C	Real Estate Other Than Home
A C	Alimony and Child Support
A C	Auto Loan
A C	Auto Loan
A C	Banks
A C	Credit Unions
A C	Savings & Loans
A C	Finance Company
A C	Finance Company
A C	Credit Card
A C	Credit Card
A C	Other
A C	Other
List any names under which credit has been previously received. TOTALS
COMMENTS
Signature required before approval of loan.

PRIVACY STATEMENT:

It is the policy of Menominee County Federal Credit Union that all personal information supplied to the credit union by our members via the Internet will remain completely confidential. The credit union will use personal information only as required to transact credit union related business between Menominee County Federal Credit Union and our members. Menominee County Federal Credit Union will not sell or otherwise distribute Internet acquired personal information, including name, address or e-mail address, to outside merchants or mailing lists.

Select which branch office and then click the Submit Application button to send the application to us via the WWW. Use an additional email if you need to give us any further information. Please put your full name in the email.

I/We hereby authorize Menominee County Federal Credit Union to investigate my/our credit record to the extent it deems necessary and to verify my/our references. I/We further authorize any credit reporting agency or person to furnish Menominee County Federal Credit Union with any information on my/our credit records. By making this application, I/we accept the terms and conditions of the line-of-credit agreement and disclosure. If my/our application is accepted, I/we assume liability for all charges incurred in any authorized use of the account.

By submitting this application you agree to the terms and conditions governing the services. Submission of this application constitutes your signature. Your signature may be required as an additional condition of these services.

Please check which office you would like your application sent to.

Menominee Branch Office Powers Branch Office Stephenson Branch Office

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All accounts at Menominee County Federal Credit Union are insured up to $100,000 by the NCUA, an agency of the Federal Government.

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