Loan Application Form

Loan Application Requirements

Notice of disclosure and verification of credit information

UNITED ENTERPRISE CREDIT UNION LIMITED LOAN APPLICATION

Are you a member?

Yes

No

Email

Phone Number

LOAN AMOUNT

APPLICATION DATE:

ACCOUNT NUMBER:

I hereby apply for a loan in the amount of

Amount

or, I hereby apply for a Consolidation loan in the amount of

Consolidation Amount

consisting of external debt

External Debt Amount

and present credit union debt to be consolidated

Credit Union Debt Amount

SECTION A: APPLICANT INFORMATION

First Name

Middle Name

Last Name

BANK ACCOUNT#

TIN#

DATE OF BIRTH

AGE

NATIONAL REGISTRATION

NAME OF SPOUSE

MARTIAL STATUS

NO. OF DEPENDENTS

AGES OF DEPENDENTS

CURRENT ADDRESS

Address Line 1

Address Line 2

City

Parish

Postal Code

Country

FORMER ADDRESS (If less than 1 year)

Address Line 1

Address Line 2

City

Parish

Postal Code

Country

NO. OF YEARS AT FORMER ADDRESS

SECTION B: EMPLOYMENT INFORMATION

CURRENT EMPLOYER

EMPLOYER'S ADDRESS

Address Line 1

Address Line 2

City

Parish

Postal Code

Country

EMPLOYER TELEPHONE

EMPLOYMENT STATUS

EMPLOYMENT POSITION

How long with the company?

(if less than 5yrs name previous company)

APPLICANT'S SALARY

TOTAL FAMILY INCOME

OTHER - ALLOWANCES

NET PAY

SPOUSE'S EMPLOYER

SPOUSE'S POSITION

SPOUSE'S SALARY

SECTION C: ASSETS & LIABILITIES

SHARES/SAVINGS IN CREDIT UNION

HOMEOWNER

HOME VALUE

SAVINGS IN BANK

MOTOR VEHICLE OWNER

MAKE

MODEL

VEHICLE VALUE

GODDARDS SHARES OWNER

GODDARDS SHARES VALUE

OTHERY PROPERTY OWNER

OTHER PROPERTY VALUE

LIABILITIES

Creditor 1

NAME OF CREDITOR 1

DESCRIPTION 1 (AUTO, HOME ETC.)

MONTHLY PAYMENTS 1

BALANCE OWING 1

Creditor 2

NAME OF CREDITOR 2

DESCRIPTION 2 (AUTO, HOME ETC.)

MONTHLY PAYMENTS 2

BALANCE OWING 2

Creditor 3

NAME OF CREDITOR 3

DESCRIPTION 3 (AUTO, HOME ETC.)

MONTHLY PAYMENTS 3

BALANCE OWING 3

SECTION D: EXPENDITURE

RENT

MORTGAGE

CREDIT CARD

HIRE PURCHASE

UTILITIES

MEDICAL

CAVE SHEPHERD

OTHER

FOOD

PROPERTY TAXES

MASSY CARD

TOTAL EXPENDITURE

RATIO %

MONTHLY INCOME

MONTHLY DEBT

UECU LOANS

DTIR (%)

TDSR (%)

SECTION E: REFERENCES (NOT LIVING AT SAME ADDRESS)

Reference #1

First Name

Last Name

Reference 1 Address

Address Line 1

Address Line 2

City

Parish

Postal Code

Country

Reference 1 Phone Number

Reference #2

First Name

Last Name

Reference 2 Address

Address Line 1

Address Line 2

City

Parish

Postal Code

Country

Reference 2 Phone Number

UECU LTD MAY VERIFY ANY INFORMATION PROVIDED TO IT BY ME/US FROM WHATEVER SOURCES IT DEEMS NECESSARY. UECU LTD IS HEREBY AUTHORIZED TO OBTAIN ANY INFORMATION IT REQUIRES RELATIVE TO MY/OUR CREDIT HISTORY OR APPLICATION FOR CREDIT AND ANY SUCH SOURCE IS HEREBY AUTHORIZED TO PROVIDE ANY SUCH REQUESTED INFORMATION. UECU LTD IS FURTHER AUTHORIZED TO DISCLOSE TO ANY CREDIT BUREAU, REPORTING AGENCY, BUSINESS, FINANCIAL INSTITUTION OR PERSON WITH WHOM I HAVE ENTERED INTO OR PROPOSE TO ENTER INTO A BUSINESS OR FINANCIAL RELATIONSHIP WITH, MY/OUR CREDIT OR FINANCIAL HISTORY OR INFORMATION AS DEEMED APPROPRIATE, LAWFUL AND NECESSARY IN THE SOLE DISCRETION OF UECU LTD OR EXPRESSLY PROVIDED BY LAW. I/WE JOINTLY AND SEVERALLY AGREE TO INDEMNIFY THE CREDIT UNION AND SAVE UECU LTD FROM ANY AND ALL CLAIMS IN DAMAGES OR OTHERWISE ARISING FROM ANY DISCLOSURE AS HEREIN AUTHORIZED.

SIGNATURES

Signature

Sign Here

SECURITY REQUIREMENTS

Life Insurance

Shares in Company

Term Insurance

Legal Mortgages

Land

Chattel Mortgages

Bill of Sale

Other