Great Horizons Federal Credit Union
Loan Application
NOTE AND COMPLETE
Married Applicants may apply for a separate account. Check the appropriate box to indicate Individual Credit or Joint Credit.
Individual Credit: Complete Applicant section. Complete Co-Applicant, Spouse, Guarantor (referred to as "Other") section: (1) about your spouse if you live in a community property state (AZ, CA, ID, LA, NM, NV, TX, WA, WI), or (2) if your spouse will use the Account, or (3) if there is a guarantor on this account. Please check box to indicate whom the information is about.
Joint Credit: Provide information on both of you by completing Applicant and Other section.

Amount Requested

Term: years

Purpose:
STATEMENT OF INTENT
Check coverage(s) desired. The credit union will disclose the cost of this voluntary insurance to you. A separate insurance election which discloses the terms and conditions must be signed for coverage to become effective.
Single Credit Life Insurance
Joint Credit Life Insurance
No, not interested
APPLICANT INFORMATION
Applicant Co-Applicant Spouse Guarantor
Use"SAA" if information is "Same As Applicant"
Name: Name:
Social Security Number: Social Security Number:
E-mail address : E-mail Address :
Birth Date: Birth Date:
Mother's Maiden Name: Mother's Maiden Name:
Home Phone: Home Phone:
Business Phone/ext: Business Phone/ext:

Present Address (Street-City-State-Zip):

Present Address (Street-City-State-Zip):
own rent
own rent
Years at this address: Years at this address:
Complete for joint credit, secured credit or if you live in a community property state:
Married
Separated
Unmarried (Single-Divorced-Widowed)
Complete for joint credit, secured credit or if you live in a community property state:
Married
Separated
Unmarried (Single-Divorced-Widowed)
List ages of dependents not listed by other applicant (exclude self): List ages of dependents not listed by other applicant (exclude self):
EMPLOYMENT INFORMATION EMPLOYMENT INFORMATION
Name and Address of Employer:

Name and Address of Employer:
Your title/grade: Your title/grade:
Supervisor's name: Supervisor's name:
Start date: Start date:
Full Time Part Time (check one) Full Time Part Time (check one)
If self-employed, type of business: If self-employed, type of business:
REFERENCES (PLEASE INCLUDE STREET, CITY, STATE, ZIP) REFERENCES (PLEASE INCLUDE STREET, CITY, STATE, ZIP)
Name and address of nearest relative not living with you:

Name and address of nearest relative not living with you:
Relationship: Relationship:
Home phone: Home phone:
INCOME INFORMATION INCOME INFORMATION
Employment Income: (net after taxes)
per
Employment Income: (net after taxes)
per

Other Income:
per

Source:

Other Income:
per

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.
DEBT DEBT
Applicant
Other
Creditor Name & Address:
Present Balance:
Monthly Payment:
Applicant
Other
Creditor Name & Address:
Present Balance:
Monthly Payment:
Applicant
Other
Creditor Name & Address:
Present Balance:
Monthly Payment:
Applicant
Other
Creditor Name & Address:
Present Balance:
Monthly Payment:
Applicant
Other
Creditor Name & Address:
Present Balance:
Monthly Payment:
Applicant
Other
Creditor Name & Address:
Present Balance:
Monthly Payment:
Applicant
Other
Creditor Name & Address:
Present Balance:
Monthly Payment:
FINANCIAL INFORMATION - If a "YES" is given to a question, please provide explanation in the comments box below.
Applicant
Other
Do you have any outstanding judgments?
Yes No
Yes No
Have you ever filed for bankruptcy or had a debt adjustment plan confirmed under Chapter 13?
Yes No
Yes No
Have you had property foreclosed upon or repossessed in the last 7 years?
Yes No
Yes No
Are you a Party in a lawsuit?
Yes No
Yes No
Are you other than a U.S. Citizen or permanent resident alien?
Yes No
Yes No
Is your income likely to decline in the next two years?
Yes No
Yes No
Are you a co-maker, co-signer or guarantor on any loan not listed above?
Yes No
Yes No

For Whom?

To Whom (Name of Creditor)?
Comments:
.
To review terms and conditions please click here.
SIGNATURES  

If there are any important changes, you will notify us in writing immediately. You also agree to notify us of any change in your name, address or employment within a reasonable time thereafter.

You promise 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 all your debts and obligations. You authorize the credit union to obtain credit reports in connection with this application for credit and for any update, renewal or extension of the credit received. If you request, the credit union will tell you the name and address of any credit bureau from which it received a credit report on you. You understand that it is a federal crime to willfully and deliberately provide incomplete or incorrect information on loan applications made to Federal Credit Unions or State Chartered Credit Unions insured by NCUA. Applicant(s) also understands that additional documents may need to be completed it credit is granted.

_________________________________
Applicant's Signature and Date
_________________________________
Other Signature and Date
By clicking on "Send Application", I accept all Terms and Conditions/Disclosures associated with this loan request.
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