Temp | Credit Union Members Loan Application

MEMBERS LOAN APPLICATION

PLEASE NOTE: This is a 'MEMBERS ONLY' application form. If you are not a member
you should contact our Administration Office on 01234 456567 or visit our website at Template Organisation

Please fully complete the form below.

qualification

Are you currently subject to any form of insolvency such as a Bankruptcy, Debt Relief Order or IVA? *

Have you sought advice regarding any form of insolvency or are you applying for any form of insolvency, this to include a Bankruptcy, Debt Relief Order or IVA *

Have you sought any arrangement or agreement to reduce your creditor payments? *

ABOUT THE LOAN

How much are you looking to borrow? *

Term of credit (in months) *

Repayment Frequency *

What is the loan for? *

PERSONAL DETAILS

Membership Number

Title *

First Name *

Surname *

Date of Birth *

Contact phone number (a mobile number if possible)

Email address *

National Insurance Number *

YOUR ADDRESS

Postcode *

Address Line 1 *

Address Line 2

line3

Town

County

Country

House Number or Name

How long have you lived at your current address? (enter number of full years) *

If you have lived at your current address for less than 3 years please provide details below

House Number or Name

Previous Address Postcode

How many individuals aged 14 years and over live in your house? (Please include yourself) *

How many children aged under 14 years live in your house? *

What is your marital status? *

Please tell us about your home *

YOUR INCOME

Monthly total of all wages after tax and any other income *

Please tell us about your main source of income

If you are employed, please provide your employers name and address

If you are unemployed, please provide details of the main benefit you receive

Name of employer or main benefit *

  Where i have indicated I am employed, I confirm that I am in a permanent contract and not under notice of redundancy or termination of employment.

Employers address (if you are unemployed enter N/A) *

YOUR EXPENDITURE

Total of all current debts (excluding mortgages) *

Monthly payments for existing loans, HP agreements, etc *

DECLARATION

Important Your Personal Information: Credit decisions and also the prevention of fraud and money laundering.

We may use credit reference and fraud prevention agencies to help us make decisions. What we do and how both we and credit reference and fraud prevention agencies will use your information is detailed in

A Guide to the use of your personal information by ourselves and at Credit Reference and Fraud Prevention Agencies

or you can call our Administration Office on 01234 456567 for a copy.

By confirming your agreement to proceed you are accepting that we may each use your information in this way.

  I accept the use of Credit Reference Agencies and declare that the information given by me on this form is true and correct, to the best of my belief.

  I consent to my personal data being held by Template Organisation for the purposes of this application and my membership with the credit union. *

To complete your application please ensure your Email address is correct and then select Apply below.