PLEASE NOTE: This is a 'MEMBERS ONLY' application form. If you are not a member
you should contact our Administration Office on 028 7962 8762 or visit our website at Ballinascreen Credit Union


The Loans Committee may request proof of income. If you are employed you may be required to present recent pay slips or current bank statements. If self-employed a copy of your up to date audited business accounts may be requested. If you are unemployed you may be required to provide details of the benefits you receive.

Personal details
Address details
About you
Benefits received

Please provide details of benefits if applicable and whether paid to you Weekly, 2 Weekly or Monthly

other income

Please tell us of any other income: (Pension or Housekeeping from family members. Amount, source & frequency)

your outgoings
Loan details

Loan repayments can be made at our office or by Standing Order (Please ask for details)

supporting documentation

To assess your appliction we require you to submit evidence of:
3 months payslip if employed
3 months bank statement
(If pay is mandated to your bank we can accept 1 payslip along with your banks statement for the last 3 months)
Any other documents to support your application such as proof of benefits, pension statement
These should be uploaded below by either a photo (jpeg) or pdf document

If you are unable to upload any documents, please contact the credit union to make alternative arrangements for providing this documentation. Loans cannot be processed until all the necessary documentation has been provided.

Bank Account Details

Please provide you bank account details below. These will be used to pay out your loan and collect payments from


Make the following declaration ONLY if you fully understand them

I declare that the statements in this Application form are complete and true to the best of my knowledge and are made for the purposes of obtaining a loan. I understand that Ballinascreen Credit Union and its representatives may rely on the statements made in this application form in reaching a decision about my Loan application. I understand that if any such statements are subsequently found to be untrue that I will have committed a criminal offence and may be liable to criminal prosecution. I understand that I may be asked to provide further information in support of this application.

  I understand that I am required to produce photographic ID plus one recent utility bill when collecting my loan if perchance my photographic identity is not held on our computer. * 
  I declare that the statements in this Application form are complete and true to the best of my knowledge * 

Data Protection Act
In accordance with the principles of the Data Protection Act, we will use your personal details for the purposes of managing your account with Ballinascreen Credit Union. Your personal details will be treated confidentially and will only be shared with other agencies for the purpose of credit referencing and debt recovery.

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