FCEFCU Loan Application Step 1 of 333%If this is an application for a separate loan, no spousal information is requested except if you are married and reside in a community property state or if community property will be used to repay the loan. A non-applicant spouse in a community property state must indicate their full name and social security number. Alimony, child support or separate maintenance need not be disclosed unless you desire such income to be considered.ApplicantName*Social Security NumberDate of Birth* Date Format: MM slash DD slash YYYY Marital StatusMarriedSeparatedUnmarried# of Dependents (Excluding Self)Please enter a number less than or equal to 20.Email Address* Work PhoneHome/Cell*Address* Street Address City State ZIP Years at this AddressPlease enter a number from 0 to 99.RentOwnMonthly PaymentEmployer*Employer Address (or Shop #)How Long Employed Here?*Occupation*Annual Base Salary* (must provide verification)Total Monthly Debt (excluding mortgage/rent)If a community property state resident, spouse must complete full name and social security number only if not a co-applicant. Leave this page blank if you do not have a co-applicant.Co-ApplicantNameSocial Security NumberDate of Birth* Date Format: MM slash DD slash YYYY Marital StatusMarriedSeparatedUnmarried# of Dependents (Excluding Self)Please enter a number less than or equal to 20.Email Address* Work PhoneHome/Cell*Address* Street Address City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Years at this AddressPlease enter a number from 0 to 99.RentOwnMonthly PaymentEmployer*Employer Address (or Shop #)How Long Employed Here?*Occupation*Annual Base Salary(must provide verification)Total Monthly Debt (excluding mortgage/rent)Loan DetailsLoan Amount*Purpose of Loan*CollateralDo you want automatic payment?YesNoAdditional NotesDownload FCEFCU DisclosuresI have downloaded the FCEFCU disclosure document. I have read, understood, and agree to be bound by the terms of the FCEFCU’s disclosures and any agreement associated with these products and services.Disclosure checkbox* I AGREE-----------------------------------By signing in the box(es) below, you certify that everything you have stated in this application is correct to the best of your knowledge and that the above information is a complete listing of what you owe. All signers agree to be liable to repay this loan as required by the Credit Union. You authorize the Credit Union to verify this information from whichever sources it deems necessary (including credit reports) and may provide others with information regarding your credit history to the extent permitted by law. You understand that the Credit Union will rely on the information in this application and your credit report to make its decision. It is a federal crime to willfully and deliberately provide incomplete or incorrect information on loan applications made to federal credit union or state chartered credit unions insured by NCUA.Applicant's Signature*Co-Applicant's Signature*CommentsThis field is for validation purposes and should be left unchanged.
