Farm Credit Employees Federal Credit Union

How to Apply
Complete all information. Incomplete applications will delay processing.

If you have any questions or problems with this application please contact the Credit union at 651-282-8881 during normal business hours,

Optional insurance to cover balance of loan in the event of death or disability is available. Contact the credit union during business hours for quotes.

Repayment

Type of Application

Individual Joint

Purpose of loan

Amount Requesting

Name

Mother's Maiden Name

Account Number

Social Security

- -

Drivers License Number

Number of Dependants
(Exclude Self)

Birthday

- -

Home Phone #

- -

Work Phone #

- -

Email Address

Address

Own or Rent

Own Rent

Years There

Previous Address (If less than 5 years)

Own or Rent

Own Rent

Years There

Complete for joint credit, or secured credit

Married Separated Unmarried

Your Employer's Name

Employer's address
Street Address: PO Box: City: St: Zip:
or shop Number

Supervisor

Occupation

Start Date

Gross Income

per	Week Month Year

# of hours worked per week

Other income

per	Week Month Year

Source

Previous Employer's Name & address if employed less than 5 years
Name: Street Address: PO Box: City: St: Zip:

Starting Date

Ending Date

Nearest relative not living with you?

Relationship

Home Phone

Their address
Street Address: PO Box: City: St: Zip:

Other Reference

Relationship

Home Phone

Their address
Street Address: PO Box: City: St: Zip:

Co-Applicant - If Applicable

Name

Mother's Maiden Name

Account Number

Social Security

- -

Drivers License Number

Number of Dependants
(Exclude Self)

Birthday

- -

Home Phone #

- -

Work Phone #

- -

Email Address

Address

Own or Rent

Own Rent

Years There

Previous Address (If less than 5 years)

Own or Rent

Own Rent

Years There

Complete for joint credit, secured credit

Married Separated Unmarried

Your Employer's Name

Employer's address
Street Address: PO Box: City: St: Zip:
or shop Number

Supervisor

Occupation

Start Date

Gross Income

per	Week Month Year

# of hours worked per week

Other income

per	Week Month Year

Source

Previous Employer's Name & address if employed less than 5 years
Name: Street Address: PO Box: City: St: Zip:

Starting Date

Ending Date

Nearest relative not living with you?

Relationship

Home Phone

Their address
Street Address: PO Box: City: St: Zip:

Other Reference

Relationship

Home Phone

Their address
Street Address: PO Box: City: St: Zip:

What You Owe	Creditor Name Other Than This Credit Union	Interest	Balance	Payment	Owed By
What You Owe	Creditor Name Other Than This Credit Union	Interest	Balance	Payment	Applicant	Other
Rent or First Mortgage
2nd Mortgage
1st Auto Loan
2nd Auto Loan
Child Care
Child Support
Credit Card
Credit Card
Other
Other

What You Own	List Location of Property or Financial Institution	Market Value	Pledged as collateral		Owned By
What You Own	List Location of Property or Financial Institution	Market Value	Yes	No	Applicant	Other
Home
Auto
Savings
Checking
Other

Other Infomation About You	Applicant		Other
Other Infomation About You	Yes	No	Yes	No
Are you a U.S. Citizen or Permanent Resident Alien?
Do you currently have any outstanding judgements 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?
Is your income likely to decline in the new two years?
Are you a co-maker, co-signer, or guarantor on any loan not listed above?

For whom (Name of others obligated on loans) To whom (Name of creditor)
You promise that everything you have stated in this application is coorect to the best of your knowledge and that the above information is a complete listing of what you owe. If there are any important changes you will notify us in writing immediatey. You authorize the Credit Union to obtain credit reports in connection with this 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 recieved a credit report on you. It is a federal crime to will fully and deliberately provide incomplete or incorrect information on loan applications made to federal credit union or state chartered credit unions insured by NCUA.

Do you agree with these conditions? Applicant

yes no

Do you agree with these conditions? Co Applicant (If Applicable)

yes no