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Application for Pre-Approval

* Required Fields
Application Type:
Please Tell Us About Yourself (Primary Borrower)
Birth Date:
 /   / 
Social Security Number:
 -   - 
Marital Status:
Address (Primary Borrower)

Do you...:
If you have been at your current address for less than 2 years, please provide information about your previous residence.

Did you...:
Contact Information (Primary Borrower)
Assets (Primary Borrower)
Employment Information (Primary Borrower)

If you have been with your current employer less than two years, please provide information on your previous employer.

Other Income: Monthly dollar amount that you recieve in alimony, child support, or separate maintenance - this income need not be revealed if you do not wish to have it considered as a basis for repaying this obligation.
Relatives (Primary Borrower)
Please list two of your nearest relatives who are not living with you.


Statement of Total Indebtedness
(Secondary Borrower)

Mortgage or Rent

Auto Loan 1

Auto Loan 2

Credit Union

Bank

Credit Card 1

Credit Card 2

Other

Child Support / Alimony / Separate Maintenance

Please tell us about yourself (Secondary Borrower)
Birth Date:
 /   / 
Social Security Number:
 -   - 
Marital Status:
Address (Secondary Borrower)
Same as Primary Borrower:

Do you...:

Did you...:
Contact Information (Secondary Borrower)
Assets (Secondary Borrower)
Employment Information (Secondary Borrower)

If the Secondary borrower has been with the current employer less than 2 years, please provide information on the Secondary Borrower's previous employer.

Other Income: Monthly dollar amount that the Secondary Borrower recieves in alimony, child support, or separate maintenance - this income need not be revealed if you do not wish to have it considered as a basis for repaying this obligation.
Relatives (Secondary Borrower)
Please list two of your nearest relatives who are not living with you.


Statement of Total Indebtedness
(Secondary Borrower)

Mortgage or Rent

Auto Loan 1

Auto Loan 2

Credit Union

Bank

Credit Card 1

Credit Card 2

Other

Child Support / Almony / Separate Maintenance

Click the "I accept the terms of the disclaimer above and submit my application"
button to send the application to us via the Internet after reading the
disclaimer below.  By clicking "I accept the terms of the disclaimer above and submit my application",
you accept the terms of the disclaimer below.


DISCLAIMER: 
I/WE HEREBY CERTIFY THAT ALL STATEMENTS MADE ARE TRUE AND COMPLETE, ARE
SUBMITTED FOR THE PURPOSE OF OBTAINING CREDIT, AND THAT THE CREDIT UNION
MAY RELY ON THEM FOR SUCH DETERMINATION.  I/WE AUTHORIZE YOU TO
OBTAIN SUCH INFORMATION AS YOU MAY REQUIRE CONCERNING THE STATEMENTS
MADE IN THIS APPLICATION, AND AGREE THAT THE APPLICATION SHALL REMAIN
YOUR PROPERTY, AND YOU ARE AUTHORIZED TO ANSWER QUESTIONS ABOUT YOUR
CREDIT EXPERIENCE WITH ME/US.



Applicant Signature:
______________________________________________________
Date:
____________________


Co-applicant
Signature
: ______________________________________________________
Date:
____________________

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