Loan App
  1. Proof of all income must accompany this application (pay stub, etc.). 
    Fax this to 733-1376.
  2. Auto loan requests must have copy of purchase order attached
    Car information needed: car make, model, year, mileage, color, and vehicle i.d. number.
Name
Email
Date
Purpose of loan
Amount Requesting

Current Loan Balance
(If Refinancing)

Loan to be repaid in months or at $ per pay or mo.


Address, if RD# provide brief description of location:
Home Phone #
Work Phone #
Spouse
Number of Dependents

Your Employer

Employer's address and phone #
Occupation
Department
Length of Employment


Income
per
# of hours worked per week

Other income
per
Source


*** PROOF OF INCOME MUST ACCOMPANY THIS APPLICATION***
Nearest relative not living with you?
Relationship

Their address 

Please fill out this application in detail to decrease processing time.  Everything that I have stated in this application and credit history is correct to the best of my knowledge.  As required, my shares may be used as security for my loan.  You are authorized to check my credit history and to answer any questions about your credit experience with me. 

Do you agree with these conditions?
yes      no

If requesting joint credit:

Spouse Name

Credit History

  Creditor Present Balance Monthly Pmt. Up to Date
Rent/Mortgage
Are you a co-maker, co-signer or guarantor on any loans?
yes      no

Have you declared bankruptcy in the last 14 years?
yes     no