General Information
Please indicate what type of loan you are applying for:
Will there be a applying for Individual or Joint Credit? Individual Joint
If applying for joint credit, please sign below to verify that you intend to apply for joint
Marital Status: Complete marital status if this loan is for:
a. Joint or secured credit, or
b. You reside in or rely on property located in a Community Property State (AZ, CA, ID, LA, NM, NV, TX, WA, WI)
Unmarried
Married
Separated
This loan is not for joint or secured credit and I do not live in the states listed above.
I have filed BK 7
Date Discharged:
I have filed BK 13 Date Discharged:
Loan Amount Requested: Loan Term Requested:
Primary Applicant:
Last Name: * Account Number: *
First Name: * Middle Name:
Social Security Number (TIN): * Date of Birth: *
Number of Dependents: Ages of Dependents:
Home Phone Number: * Work Phone Number: *
Cell Phone Number: Email Address:
Drivers License #: * Drivers License State: *
Home Address
Address 1: *
Address 2:
City: * State, Zip: *
Time at Current Residence: * Residence Type: Own Rent Other:
Monthly Payment:
Previous Address, if less than 2 years
Address 1:
Address 2:
City: State, Zip:
Time at Previous Residence: Residence Type: Own Rent Other:
Present Employer
Name: * Phone Number: *
Employment Status: Full Time Part Time Temp Retired Other (please specify):
Job Title: * Job Start Date: *
Gross Salary: * per Year Month Hour
Other Income: per Year Month Hour
Other Income Source:  
Alimony, child support or separate maintenance income need not be revealed if you do not wish to have it considered as a basis for repaying this obligation.
Previous Employer (if less than 3 years)
Name: Phone Number:
Employment Status: Full Time Part Time Temp Retired Other (please specify):
Job Title: Job Start Date:
Job End Date:
Gross Salary: per Year Month Hour
 
Joint-Applicant
Last Name: Member Number:
First Name: Middle Name:
Social Security Number: Date of Birth:
Number of Dependents: Ages of Dependents:
Home Phone Number: Work Phone Number:
Cell Phone Number: Email Address:
Drivers License #: Drivers License State:
Home Address
Address 1:
Address 2:
City: State, Zip:
Time at Current Residence: Residence Type: Own Rent Other:
Monthly Payment:
Previous Address
Address 1:
Address 2:
City: State, Zip:
Time at Previous Residence: Residence Type: Own Rent Other:
Present Employer
Name: Phone Number:
Employment Status: Full Time Part Time Temp Retired Other (please specify):
Job Title: Job Start Date:
Gross Salary: per Year Month Hour
Other Income: per Year Month Hour
Other Income Source:  
Alimony, child support or separate maintenance income need not be revealed if you do not wish to have it considered as a basis for repaying this obligation.
Previous Employer (if less than 3 years)
Name: Phone Number:
Employment Status: Full Time Part Time Temp Retired Other (please specify):
Job Title: Job Start Date:
Job End Date:  
Gross Salary: per Year Month Hour
Additional Information
Special Instructions/Comments:

To: Chicago Post Office Employees Credit Union

* I am providing the above information for the purpose of obtaining an account and I authorize you to obtain additional information concerning any of the statements I have made. I also authorize you to make inquiries you feel are necessary to determine my credit worthiness including, but not limited to, obtaining credit reports from credit reporting agencies and other credit information from other sources. I also agree to provide additional documents as requested including, but not limited to picture ID, most recent pay stub and other verification as requested. Loan approval will also be based on your credit score and credit report. Pledges 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 Financial Institution, information concerning me or my affairs. (Sec. 1014, title 18, U.S. Code makes it a Federal Crime to knowingly make a false statement on this application.)

Primary Applicant Signature: Date:
Co-Applicant Signature: Date:
* I have read the Privacy Policy, Notices, USA Patriot Act and the Funds Availability Policy that are posted on this website.