Coweta Cities & Co. EFCU Coweta Cities & County Employees Federal Credit Union NEWNAN The City of Homes
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Loan Application
Married Applications: May apply for a separate account.
Individual Credit: You must complete the Applicant section about yourself and the Other section about your spouse if:
1. you live in or the property pledged as collateral is located in a community property state (AK, AZ, CA, ID, LA, NM, NV, TX, WA, WI),
2. your spouse will use the account, or
3. you are relying on your spouse's income as a basis for repayment. If you are relying on income from alimony, child support, or separate maintenance, complete the Other section to the extent possible about the person on whose payments you are relying.
Joint Credit: If you are applying with another person, complete the Applicant and Other sections.
Guarantor: Complete the Other section if you are guarantor on an account/loan.
LOANLINER Account/Loan:
(Including ATM/Debit Card Access to the Account if Available
)
Amount Requested $ _______________________
Purpose/Collateral:  _______________________
Repayment:

 
 
 
APPLICANT
NAME _________________________________________ ACCOUNT NUMBER___________
SOCIAL SECURITY NO.  ______________________
DRIVER LICENSE NUMBER /STATE
___________________/_________
 
PRESENT ADDRESS: _________________________
CITY:________________ 
STATE:__________
ZIP:_________________ LENGTH AT RESIDENCE:__

BIRTH DATE  _____________
HOME PHONE  ________________
BUSINESS PHONE/EXT  ____________
WHAT YOU OWE
WHAT YOU OWE CREDITOR/NAME OTHER THAN THIS CREDIT UNION
(ATTACH ADDITIONAL SHEETS IF NECESSARY)
% RATE PRESENT BALANCE MONTHLY PAYMENT
1.        
2.        
3.        
4.        
5.        

LIST ANY NAME UNDER WHICH YOUR CREDIT REFERENCES AND CREDIT HISTORY CAN BE CHECKED:________________________

_____________________________________      __________________________________    _______________________________

COMPLETE FOR JOINT CREDIT, SECURED CREDIT OR IF YOU LIVE IN A COMMUNITY PROPERTY STATE
STATE:________________ MARITAL STATUS:_________________
OTHER INFORMATION ABOUT YOU (IF YOU ANSWER "YES" TO ANY QUESTION ORTHER THAN #1, EXPLAIN ON AN ATTACHED SHEET)
1. ARE YOU A U.S. CITIZEN OR PERMANENT RESIDENT ALIEN?________________________________
2. DO YOU CURRENTLY HAVE ANY OUTSTANDING JUDGMENTS OR HAVE YOU EvER FILED FOR BANKRUPTCY, HAD A DEBT ADJUSTMENT PLAN CONFIRMED UNDER CHAPTER 13, HAD PROPERTY FORECLOSED UPON OR REPOSSESSED IN THE LAST 7 YEARS, OR BEEN A PARTY IN A LAWSUIT? ______________________________
3. IS YOUR INCOME LIKELY TO DECLINE IN THE NEXT TWO YEARS?________________________
4. ARE YOU A CO-MAKER, CO-SIGNER OR GUARANTOR ON ANY LOAN NOT LISTED ABOVE? _____________
FOR WHOM (Name of Others Obligated on Loan):________________________________________ TO WHOM (Name of Creditor)______________________
EMPLOYMENT AND INCOME
NAME AND ADDRESS OF EMPLOYER____________________
CITY:____________________
STATE:__________
ZIP:__________________ TITLE:_______________________
SUPERVISOR'S NAME:_____________________________
IF SELF EMPLOYED, TYPE OF BUSINESS:____________________________________

$ __________ PER__________
START DATE________________
MILITARY: IS DUTY STATION TRANSFER EXPECTED DURING THE NEXT YEAR?
WHERE:____________________________________________ ENDING/SEPARATION DATE:___________________________
OTHER INCOME
ALIMONY, CHILD SUPPORT, OR SEPARATE MAINTENANCE INCOME NEED NOT BE REVEALED IF YOU DO NOT CHOOSE TO HAVE IT CONSIDERED.
OTHER INCOME $ _____________ PER _____________ SOURCE ________________________________
  $ _____________ PER _____________ SOURCE ________________________________
  $ _____________ PER _____________ SOURCE ________________________________
  $ _____________ PER _____________ SOURCE ________________________________
REFERENCE (NAME AND ADDRESS OF NEAREST RELATIVE NOT LIVING WITH YOU)
1. NAME:__________________________________________ TELEPHONE NUMBER:_____________________________________________
ADDRESS:__________________________________________________________________________________________________________________________
2. NAME: __________________________________________ TELEPHONE NUMBER:_____________________________________________
ADDRESS:__________________________________________________________________________________________________________________________
 
STATE LAW NOTICES
OHIO RESIDENTS ONLY: the Ohio laws against discrimination require that all make credit equally available to all creditworthy customers, and that credit reporting agencies maintain separate credit histories on each individual upon request. The Ohio Civil Rights Commission administers compliance with this law.
WISCONSIN RESIDENTS ONLY: (1) No provision of any marital property agreement, unilateral statement under Section 766.70 will adversely affect the rights of the Credit Union unless the Credit Union is furnished a copy of the agreement, statement or decree, or has actual knowledge of its terms, before the credit is granted or the account is opened. (2) Please sign if you are not applying for this account or loan with your spouse. The credit being applied for, if granted, will be incurred in the interest of the marriage or family of the undersigned.
Signature____________________________________ Date_________________
TERMS & CONDITIONS
1. You promise that everything you have stated in this application is correct to the best of your knowledge. If there are any important changes you will notify use in writing immediately You authorize the Credit Union to Obtain credit reports in connection with its 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. 2. If you are applying for a credit card, you understand that the use of your card will constitute acknowledgment of receipt and agreement to the terms of the credit card agreement and disclosures. You grant us a security interest in all individual and joint share and/or deposit accounts you have with us now and in the future to secure your credit card account. When you are in default, you authorize us to to apply the balance in these accounts to any amounts due. Shares and deposits in an individual Retirement Account, and any other account that would lose special tax treatment under state or federal law if given as security, are not subject to the security interest you have given in your share and deposits.
Signature____________________________________ Date_________________


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