Home Equity And Homeowner Loan Application

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United States Senate
HOME EQUITY AND
TION
Federal Credit Union
HOMEOWNER LOAN APPLICA
DATE
APPLICANT ACCOUNT NO.
CO-APPLICANT ACCOUNT NO.
Amount Requested:
Line of Credit $ ________________
Closed End $ ________________
Purpose:
Approximate Value:
Property Type:
Single Family Home
Condominium
Townhouse
Other
Property Address:
MARRIED APPLICANTS may apply for a separate account. Check the type of credit account for which you wish to apply.
Individual Credit – You must complete the applicant section about yourself and the other section about your spouse if: (1) You live in a community property state
(AK, AZ, CA, ID, LA, NM, NV, P.R., TX, WA, WI); (2) your spouse will use the account; or (3) you are relying on your spouse’s income as a source of repayment.
Joint Credit – If you are applying for a joint account or an account that you and another person will use, you must complete the applicant and other section.
________ ________ Initial here if you intend to apply for Joint Credit
APPLICANT
SPOUSE
CO-APPLICANT
CO-SIGNER
Complete for secured credit or if you live in a community property state.
Complete for secured credit or if you live in a community property state.
MARRIED
SEPARATED
UNMARRIED (Single, Divorced, Widowed)
MARRIED
SEPARATED
UNMARRIED (Single, Divorced, Widowed)
FIRST NAME
INITIAL
LAST NAME
FIRST NAME
INITIAL
LAST NAME
SOCIAL SECURITY NO.
DRIVER’S LICENSE NO. & STATE
BIRTH DATE
SOCIAL SECURITY NO.
DRIVER’S LICENSE NO. & STATE
BIRTH DATE
HOME PHONE NO.
NO. OF DEP.
AGE OF DEPENDENTS OTHER
HOME PHONE NO.
NO. OF DEP.
AGE OF DEPENDENTS OTHER
MOTHER’S MAIDEN NAME
E-MAIL ADDRESS
RELATIONSHIP TO APPLICANT
CURRENT STREET ADDRESS
APT. NO.
SINCE
CURRENT STREET ADDRESS
APT.
SINCE
NO.
CITY
STATE
ZIP CODE
CITY
STATE
ZIP CODE
FORMER STREET ADDRESS
YEARS THERE
FORMER STREET ADDRESS
YEARS THERE
CITY
STATE
ZIP CODE
CITY
STATE
ZIP CODE
PERSONAL REFERENCE
RELATIONSHIP
PERSONAL REFERENCE
RELATIONSHIP
EMPLOYMENT & INCOME
If you are self-employed, attach a financial statement and your most recent income tax return.
CURRENT EMPLOYER
HIRE DATE
CURRENT EMPLOYER
HIRE DATE
WORK PHONE NO.
WORK PHONE NO.
POSITION
MONTHLY NET INCOME
POSITION
MONTHLY NET INCOME
$
$
FORMER EMPLOYER (if current less than 2 years)
FORMER EMPLOYER (if current less than 2 years)
OTHER INCOME
You need not list income from alimony, child support or separate maintenance unless you wish it considered for purposes of granting this credit.
SOURCE OF OTHER INCOME
FREQUENCY
MONTHLY INCOME
SOURCE OF OTHER INCOME
FREQUENCY
MONTHLY INCOME
1.
$
1.
$
2.
$
2.
$
ASSETS & DEPOSITS
Please check the appropriate box below. INDICATE:
A - Applicant
OR
C - Spouse/Co-Applicant
CURRENT
CURRENT
CHECK ONE “
CHECK ONE “
FINANCIAL INSTITUTION
FINANCIAL INSTITUTION
BALANCE
BALANCE
A
C
TYPE
A
C
TYPE
$
$
$
$
$
$
AUTO 1
YEAR
MAKE
VALUE
AUTO 1
YEAR
MAKE
VALUE
$
$
REAL ESTATE
VALUE
OTHER ASSETS
VALUE
$
$
2004 ConmarSystems, Inc., Peachtree City, GA 30269 - Rev. 6/09 EFORM 12927-1
ARD 7/09

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