Loan Application - Hospitality FCU

Will there be a co-applicant on this loan application?	Yes No
Type of loan requested:
Amount requested:

Last Name **	First Name **	Social Security Number **
Date of Birth **	Home Phone **	E-mail Address **
Mother's Maiden Name **	Home Address **
City **	State **	Zip **
Length of residence **		Rent Own **

** All fields marked above are required information

Employment

Present Employer	Length of Employment	Position
Employer Phone	Gross Monthly/ Yearly Income	Other Income and Source*
Time in Industry

References (related)

Name	Home Address
City	State	Zip
Home Phone

References (non-related)

Name	Home Address
City	State	Zip
Home Phone

Credit References/Assets

Mortgage (rent) Payment

Mortgage Balance Approx.

Market Value (house)

Auto Year	Make	Model	Balance Owed
Auto Year	Make	Model	Balance Owed
Other Assets (optional):

Co-Applicant Information

Name	Relationship
Social Security Number	Date of Birth
Home Address		Home Phone
City	State	Zip
Length of Residence		Rent Own
Value	Balance	Payment
Employer	Length of Employment	Employer Phone
Gross Monthly/ Yearly Income		Position
Time in Industry		Other Income and Source*
*Alimony or child support or maintenance payments are optional information and need not be revealed if the applicant does not choose to rely on such income in applying for credit.

Please note: Income verification may be required; other information may be required.

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 of a Federal Credit Union.)

Applicant Signature ___________________________________________________________________	Date __________
Co-Applicant Signature ___________________________________________________________________	Date __________

We will begin processing this request immediately after we receive it. Please note that a $20 application fee may be charged to your Share Account.

For your records, please PRINT a copy of this completed application before selecting the SUBMIT button