NFCU | Credit Union Members Loan Application

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PLEASE NOTE: This is a 'MEMBERS ONLY' application form. If you are not a member
you should contact our Administration Office on 01603 501301 or visit our website at Norfolk First Credit Union

Please fully complete the form below.

In making this application, I confirm I am not a bankrupt, involved in an Individual Voluntary Arrangement, Debt Relief Order or in agreements with creditors for reduced payments or have plans to be.

Loan details

How much are you looking to borrow? *

Term of credit (in months) *

Repayment Frequency *

What is the loan for? *

In addition to my loan repayments, I agree to save (minimum £10.00 a month) *

Personal details

Membership Number

Title *

First Name *

Surname *

Date of Birth *

National Insurance Number *

Address details

Postcode *

Address Line 1 *

Address Line 2

Address Line 3

Town

County

Country *

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

Contact phone number (a mobile number if possible) *

Home Telephone No

Email *

about your home

Are you a lone parent with dependent children? *

How many people aged 18 years and over live in your house? (Please include yourself) *

How many children aged under 18 years live in your house? *

What is your marital status? *

Please tell us about your home *

your income

Please tell us your income. Include any benefits and pensions you receive as well as salary from employment.

Are you in full time employment where full time is over 30 hours per week? *

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 *

Employer's address (if you are unemployed enter N/A) *

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.

Your expenditure

Total of all current debts (excluding mortgages) *

Monthly payments for existing loans, HP agreements, etc *

your bank details

Please provide your bank details. These will be used to transfer loan funds to

Bank/Building Society *

Bank sort code (6 digits) *

Bank account number (8 Digits) *

Please provide a copy of your latest bank statement. This should be a photograph in jpg or jpeg format or pdf *

Please use this if you need to upload an additional page of your latest bank statement. This should be a photograph in jpg or jpeg format or pdf

Your health

Please select the health statement that applies to you *

If you selected 'I have or am being treated' above, please provide details

declaration

DECLARATION

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

You can call our Administration Office on 01603 501301 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 Norfolk First Credit Union for the purposes of this application and my membership with the credit union. *

I authorise the Credit Union to contact any third party it deems necessary, including but not limited to, employers or credit reference agencies for reports or information. *

I agree that if I default on repayments, information about my loan may be passed on to the Department for Work and Pensions for their consideration of deductions from the benefits that I am or will become entitled to. *

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