Loan Liner Application Form
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3Norfolk Fire Department Fire Department Credit Union
4100 E. Virginia Beach Blvd Norfolk, VA 23502
Loan Liner A
pplication
Loan Request
Member Name: ______________________________________
Member Number: _______________________________________
Phone (Home) __________ (Work) __________ (Cell) __________
Submit valid proof of all income (2 current pay stubs) required with each request
Please read and complete the following questions:
Failure to complete this document will result in a delay and/or denial of the loan request
Do you have any outstanding payday loans? If so, list to whom and amount owed.
Yes
No
Do you pay spousal and/or child support? If so, please list amounts.
Yes
No
Have you consulted an attorney with in the last six months? If so, why?
Yes
No
Do you have child care expenses? If so, how much
Yes
No
Have you ever filed bankruptcy? If so, when and why
Yes
No
Do you owe back taxes? If so, to whom and amount owed.
Yes
No
Are you currently making payments on a 401K loan? Please specify amount.
Yes
No
Do you have any outstanding judgments or garnishments? If so, to whom and amounts.
Yes
No
In your own words, please indicate the specific purpose of this loan: (Personal is not an acceptable reason)
Loan Application
* Indicates information required
Submitting this form online does not indicate loan approval. APRs and other required cost disclosures are may be viewed on
the rates page or may be obtained in person at NFDFCU.
For Individual Credit: Obtaining credit alone.
You must complete the Applicant section about yourself and the other section about your spouse if
You live in or the property pledged as collateral is located in one of the following community property states: AK,
AZ, CA, ID, LA, NM, NV, TX, WA, WI
Your spouse will use the account
You are relying on your spouse’s income as a basis for repayment.
If you are relying on income from alimony, child support, or separation maintenance, complete the “Other” section
to the extent possible about the person on whose payment you are relying.
For Joint Credit: Obtaining credit with another person -- Complete both Applicant and Other sections
Guarantor: Co-signer -- “Other” section must be completed by the guarantor
Married Applicants -- May apply for separate account
Type of Loan/Credit
Loan Liner
Individual
Joint
(Including ATM/Debit Card Access to Account, if available)
Amount Requested:
Purpose/Collateral:_________________
See disclosure Table or Agreement for Terms
Credit Limit Requested
Authorized User Name:
Repayment:
Payroll Deduction
Cash
Military Allotment
Automatic Payment
Payment Protection:
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 Disability Insurance
Single Credit Life Insurance
Joint Credit Life Insurance
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