Gale Credit Union online banking on laptop

Loan Application

* Required Fields

Effective October 1, 2003

In accordance with section 326 of the USA Patriot Act, Gale Credit Union is required by Federal law to obtain, verify, and record information that identifies each person who opens an account or is being added as a signatory to a new or existing account. In some cases, identification will be requested for those banking with us prior to the effective date of the customer identification requirements because original documentation was not obtained with the opening of the accounts.

What this means for you:

When you open an account or are going to be added as a signatory to an account, we will ask for you name, address, date of birth, and other information that will allow us to identify you. We may also ask to see your driver's license or other identifying documents.

Member Type:

Current Member

New Member

Member Number:

Purpose of Loan:

Loan Type or Collateral:

Term:

Estimated Loan Amount Requested:

Applying for a Joint Account:

Yes

This application initiates the loan process. Final signature(s) will be required to advance funds, including signatures for joint applicants. We will contact you the next business day.

PRIMARY BORROWER: PLEASE TELL US ABOUT YOURSELF

Full Name:

Street Address:

Street Address 2:

City:

State:

ZIP:

Years Living There:

Cell Phone:

Home/Work Phone:

Social Security Number:

- -

Birth Date:

/ /

E-Mail Address:

PRIMARY BORROWER: PLEASE TELL US ABOUT YOUR JOB

Current Employer:

Years Working There:

Phone Number:

Position or Job Title:

Gross Montly Income:

Note: 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

Other Income:

Source of Other Income:

CO-BORROWER: PLEASE TELL US ABOUT YOURSELF

Full Name:

Street Address:

Street Address 2:

City:

State:

ZIP:

Years Working There:

Cell Phone:

Home/Work Phone:

Social Security Number:

- -

Birth Date:

/ /

E-Mail Address:

CO-BORROWER: PLEASE TELL US ABOUT YOUR JOB

Current Employer:

Years Working There:

Phone Number:

Position:

Gross Montly Income:

Note: 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.

Other Income:

Source:

Monthly Debt Payments

Mortgage Loan

Payment to:

Monthly Payment:

Rent

Rent Payment to:

Monthly Payment:

Auto Loan

Vehicle:

Payment to:

Monthly Payment:

Auto Loan #2

Vehicle:

Payment to:

Monthly Payment:

Credit Card

Payment to:

Monthly Payment You Pay:

Other Loan

Description of Debt:

Payment to:

Monthly Payment:

Amount you pay in alimony or child support (if any):

Are you a Co-Borrower on any other loans?

Yes

If yes, for whom:

Monthly Payment:

AGREEMENT

DISCLAIMER: I/WE HEREBY CERTIFY THAT ALL STATEMENTS MADE ARE TRUE AND COMPLETE, ARE SUBMITTED FOR THE PURPOSE OF OBTAINING CREDIT, AND THAT THE CREDIT UNION MAY RELY ON THEM FOR SUCH DETERMINATION. WE UNDERSTAND THAT FEDERAL LAW REQUIRES THE VERIFICATION OF IDENTIFICATION FOR ALL NEW ACCOUNTS SHOULD I NOT HAVE AN EXISTING ACCOUNT. I/WE AUTHORIZE YOU TO OBTAIN SUCH INFORMATION AS YOU MAY REQUIRE CONCERNING THE STATEMENTS MADE IN THIS APPLICATION AND PROPER IDENTIFICATION, AND AGREE THAT THE APPLICATION SHALL REMAIN YOUR PROPERTY, AND YOU ARE AUTHORIZED TO ANSWER QUESTIONS ABOUT YOUR CREDIT EXPERIENCE WITH ME/US.

Yes:

I accept the terms of the disclaimer above and submit my application.

Security Code: