Lanier Federal Credit Union
LANIER

LOAN APPLICATION
PLEASE COMPLETE ALL SECTIONS.  RED SELECTIONS ARE REQUIRED
(If a requried field does not apply to you type N/A)
Check Box if Applicants are applying jointly Joint Borrowers Initials
      Referred By
 
DATE
Loan Type: Personal Collateral Secured Other
  Collateral Offered:
Repayment: Payroll Deduction Automatic Transfer Cash
MARRIED APPLICANTS MAY APPLY FOR INDIVIDUAL ACCOUNTS. INDICATE BELOW THE TYPE OF CREDIT WANTED
INDIVIDUAL CREDIT: Complete Applicant Section. Complete other section if the following applies: You Live in a community property state (AZ, CA, ID, LA, NM, NV, P.R., TX, WA, WI) or your spouse will use the account - You are relying on your Spouse/Co-Applicant's income as a source of repayment.
Primary Applicant 
Married  
Separated  
Unmarried single, divorced, widowed
Account Number Purpose of Loan
Requested Amount $
   
Name
Address Line 1
Address Line 2
City
State
Zip Code
Social Security Number
Date of Birth
Home Phone Number
Cell Phone Number
Drivers License Number Driver License State
Employer
Employer City
Job Title
Employer Since Date
Work Phone Number
Gross MONTHLY Income $
Previous Employer
OTHER INCOME - You need not list income from alimony, child support or separate maintenance unless you wish it to considered for purposes of granting this credit.
Additional Income $ Additional Income Frequency
Additional Income Source    
       
Co-Applicant 
       
Name  
Social Security Number Date of Birth
Phone Number Cell Phone Number
Gross MONTHLY Income $    
Employer Employer City
Job Title  
Employed Since Date Work Phone Number
Drivers License Number Drivers License State
Previous Employer    
Other Information
Rent $
Mortage $
   
Estimated Value $ Estimated Balance $
Child Care Payment $ Child Support Payment $
Description of Title Assets
Estimated Value $ Pledged as Collateral YES NO
Personal Reference
Personal Reference Phone
Personal Reference Address  
Relationship    
Please answer the following questions.
Please indicate A= Applicant C = Co-Applicant A C
  YES NO YES NO
1. Have you ever filed a petition for bankruptcy?
          Date CHAPTER 7 or CHAPTER 13        
2. Have you ever had an auto or furniture repossessed or property foreclosed upon?
          Date        
3. Are you a co-maker or co-signer of any loan or lease?
          For whom?        
          Where ?        
4. Do you have any past due bills?
5. Is any income you have listed likely to be reduced in the next two years?
6. Have you ever had credit in any other name?
          What name?        
7. Have you any suits pending, judgments filed, alimony or support awards against you?
8. Are you other than a U.S. Citizen or permanent resident alien?
CREDIT INSURANCE REQUEST FOR COVERAGE
Complete this insurance disclosure.
Credit Life and/or Credit Disability Insurance is not required to obtain credit under this plan and will be included only if requested immediately below by the APPLICANT. The insurance rates are shown below. Each month the insurance charge is calculated by multiplying the total of outstanding principal balance by the rate shown. You must be under the age 71 for the life insurance. You must be under age 66 for disability insurance and you must be actively at work full time for wages or profit for the insurance to take effect. If coverage is selected and you are eligible, you will be charged a premium and given a Certificate of Insurance from Cherokee National Life Insurance Co., which provides the important terms of this coverage. Read it carefully. If you do not check "Yes" below, no coverage will be added nor in force.

MONTHLY PREMIUM RATES PER $100 TOTAL OF OUTSTANDING PRINCIPAL BALANCE
YOU MUST CHECK ONE OR MORE OF THE BOXES BELOW

SINGLE COVERAGE CREDIT LIFE INSURANCE: Single Coverage $0 .07 YES NO
JOINT COVERAGE CREDIT LIFE INSURANCE: Single Coverage $0.105 YES NO
SINGLE COVERAGE CREDIT DISABILITY INSURANCE: Single Coverage $0.20 YES NO

By checking here I/we have applied for Credit Insurance. I/we authorize you to add the required premiums to our Account, charge a finance charge on the premiums at the rate which applies to our Account, and forward such premiums to the Insurance Company.

By submitting this application to the Credit Union, I/we promise that everything is correct to the best of my/our knowledge and that the above information is a complete listing of my/our debts and obligations. I/we authorize the Credit Union to obtain credit reports in connection with this loan application and for any update or extension of the credit received. I/we also authorize the Credit Union to perform any investigation necessary in obtaining both the loan decision as well as the membership qualification. I/we understand that the Credit Union will rely on both the representations I/we make in this application and the contents of any credit report it obtains when deciding whether to grant the credit requested. I/we agree to immediately notify you of changes to any of the information provided in this application. I/we agree that my/our account will be subject to the terms and conditions of all applicable agreements and disclosures that will accompany the funds when issued; and that a photocopy or facsimile of this application shall be as binding as the original. I/we understand that if for any reason the applicant or co-applicant is not eligible for membership, the loan approval may be rescinded.

By submitting this application electronically, I/we agree to the same terms that apply to a signed application. If there is a co-applicant on this loan, that co-applicant has authorized the submission of this application. This electronic submission qualifies as my/our signature.

Note: Make sure all required fields are completed correctly.
Please click on the Submit button only one time.
The credit union will respond to your e-mail within one business day.
Please do not use e-mail to request transactions to your account.


Lanier Federal Credit Union
3718 Mundy Mill Rd
Oakwood, GA 30566
(770) 503-1865 (fax)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

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