TRIBUNE CREDIT UNION
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Credit Application
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Book #_______
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Note #______
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Date___________
Married Applicants may apply for a separate account. Check the appropriate box to indicate Individual Credit or Joint Credit. Individual Credit: Complete Applicant section.
Complete Co-applicant, Spouse, Guarantor (referred to as "Other") section: (1) about your spouse if you live in a community property state (AZ, CA, ID, LA, NM, NV, TX,
WA, WI), or (2) if your spouse will use the Account. Please check the box to indicate whom the information is about. Joint Credit: Provide information about both of you by
completing Applicant and Other section.
You REQUEST AN ADVANCE OF $____________________ Purpose: ______________ For a period of: _________
Installments of: _______________ Collateral: __________________________________________________________
Repayment:
Payroll Deduction
Cash
Automatic Payment
Military Allotment
[] Credit Disability Insurance
Check coverage if 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.
APPLICANT
[]CO-APPLICANT []SPOUSE []GUARANTOR
Please print in ink or type
Please print in ink or type
NAME (Last - First - Initial)
NAME (Last - First - Initial)
DRIVER’S LICENSE NUMBER/STATE
DRIVER’S LICENSE NUMBER/STATE
ACCOUNT NUMBER
SOCIAL SECURITY NUMBER
ACCOUNT NUMBER
SOCIAL SECURITY NUMBER
BIRTH DATE
HOME PHONE
BUSINESS PHONE (EXT)
BIRTH DATE
HOME PHONE
BUSINESS PHONE (EXT)
PRESENT ADDRESS (Street - City - State - Zip) Years at this address
PRESENT ADDRESS (Street - City - State - Zip) Years at this address
OWN [ ]
OWN [ ]
RENT[ ]
RENT [ ]
PREVIOUS ADDRESS (Street - City - State - Zip)
PREVIOUS ADDREES (Street - City- State- Zip)
OWN [ ]
OWN [ ]
RENT[ ]
RENT [ ]
COMPLETE FOR JOINT CREDIT, SECURED CREDIT OR IF YOU LIVE IN A
COMPLETE FOR JOINT CREDIT, SECURED CREDIT OF IF YOU LIVE IN A
COMMNITY PROPERTY STATE.
COMMUNITY PROPERTY STATE.
MARRIED [ ] SEPARATED [ ] UNMARRIED Single - Divorced - Widowed) [ ]
MARRIED [ ] SEPARATED [ ] UNMARRIED Single - Divorced - Widowed [ ]
LIST AGES OF DEPENDENTS NOT LISTED BY OTHER APPLICANT
LIST AGES OF DEPENDENTS NOT LISTED BY OTHER APPLICANT
(EXCLUDE SELF)
(EXCLUDE SELF)
Name and address of employer
Name and address of employer
Starting/Ending Date
Starting/Ending Date
Title/Grade
Supervisor
Title/Grade
Supervisor
If employed in current position less than five years, complete previous employer name
If employed in current position less than five years, complete previous employer name
and address.
and address.
Starting/Ending Date
Starting/Ending Date
Name & address of creditors of debts paid off
Phone
Name & address of creditors of debts paid off
Phone
Name & address of nearest relative not living with you. Phone-Relationship
Name & address of nearest relative not living with you. Phone-Relationship
Name & address of personal friend - not a relative
Phone
Name & address of personal friend - not a relative
Phone
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