Staley Credit Union Loan Application
To apply for an SCU Loan, print the application, fill out the information and return it to SCU.
Type of Loan Applying For
_____ Vehicle Loan
_____ Home Equity Loan
_____ Signature Loan Amount Requested: $___________________________
Date: ____________________________
PRIMARY APPLICANT
Last Name __________________________________________________
First Name _________________________________________________
Address: __________________________________________________
City: _____________________ State ___________ Zip _______
Home Telephone: (_______)__________________________________________
Social Security #: __________________________________________________
Member Account #: __________________________________________________
E-Mail Address: __________________________________________________
Gross Monthly Income: __________________________________________________
Name of Employer: ___________________________________________________
Employer City: ___________________________________________________
Employer Telephone #: ___________________________________________________
Mtg. Holder/Landlord: ___________________________________________________
Monthly Payment: ___________________________________________________
JOINT APPLICANT
Last Name __________________________________________________
First Name _________________________________________________
Address: __________________________________________________
City: _____________________ State ___________ Zip _______
Home Telephone: (_______)__________________________________________
Social Security #: __________________________________________________
Member Account #: __________________________________________________
E-Mail Address: __________________________________________________
Gross Monthly Income: __________________________________________________
Name of Employer: ___________________________________________________
Employer City: ___________________________________________________
Employer Telephone #: ___________________________________________________
Mtg. Holder/Landlord: ___________________________________________________
Monthly Payment: ___________________________________________________
Alimony, child support, or separate maintenance income need not be listed unless you choose to have such income considered regarding extension and repayment of the credit requested.
Source of Other Income:
_______________________________________________________Note: Income verification required.
I/We promise that everything stated in this application is correct to the best of my/our knowledge. I/We authorize the Credit Union to obtain credit reports in connection with this application for credit and for any update, renewal or extension of the credit received. Upon request, the Credit Union will tell me/us the name & address of any credit bureau from which it received a credit report. I/We understand that it is a federal crime to willfully and deliberately provide incomplete or incorrect information on this loan application. All loan requests subject to credit approval.
X________________________________ X__________________________________
Applicants Signature Date Joint Applicants Signature Date
Application must be signed to process.
ASI INSURED
-- Equal Housing LenderTo submit your application:
Fax us at: 217-872-5986
Call us at: 800-223-8356
Mail us at: Staley Credit Union, P.O. Box 2290, Decatur, Illinois 62524-2290
Or drop your application by your local SCU office.