* Member Number: if not a member put NONE
*Loan Term Requested:
I certify that statements on this application are true and complete. I authorize any person, association, firm or corporation to furnish, on request of this Credit Union, information concerning me or my affairs. (Sec. 1014, Title 13, U.S. Code makes it a Federal Crime to knowingly make a false statement on this application.) Income verification is required. Other information may be required. Loan Approval and Interest Rate is determined by your credit history. By clicking the submit button below, I hereby apply for credit with your credit union. Further, I agree to and accept the terms of the Disclosure.
To help the government fight the funding of terrorism and money laundering activities, Federal law requires all financial institutions to obtain, verify, and record information that identifies each person who opens an account. This policy is in compliance with the USA PATRIOT Act's Customer Identification Policy (CIP). In opening the account, the person will be asked for the following information: name, date of birth, street address, and identification number. Documents that will be accepted for verification of identity include current/active government-issued identification bearing a photograph, such as a driver's license or passport, social security card, or worker ID. We will also verify identification by calling ChexSystems or running a credit report.