A&S Federal Credit Union Loan Application

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Applicant Information:
Name:
Account Number:
E-mail address:
Social Security #:
Birth Date:
Driver's License Number:
Home Phone:
Cell Phone:
Present Address:  
Street:
City:
State:
Zip:
How many years have you lived at your current address?
Do you rent or own? Rent Own
Rent/Mortgage Monthly Payment: $
Current Employer:
Employer's Phone:
Date Started:
Job Position/Title:
Est. Monthly Salary: $
   
Co-Applicant Information:
Name:
Cu Account #(If any):
Social Security #:
Birth Date:
Current Employer:
Employer's Phone:
Date Started:
Job Position/Title:
Est. Monthly Salary: $
   
Loan Information:
Type of Loan:
How many years to pay this back?
Amount Requested: $
Would you like credit disability insurance on your loan? No Yes
Would you like credit life insurance on your loan? No Yes
If a vehicle loan, please
describe the year, make,
model, VIN number, and
the dealership you are
purchasing from.
   
Debts:
Debtor Current Balance Monthly Payment Consolidate Into New Loan?
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
If you have any other information you would like us to consider, or any comments or suggestions, please enter them  here:
By submitting this form, you hereby grant permission to the Credit Union to gather any relevant data on you necessary to complete your Loan application, such as credit reports. This is the first step in the loan process, you will be required to fill out and sign additional paperwork in person.
 

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