Membership Identification

* Membership Area
* Relationship

Type of Credit Requested

* Loan Type
Secured Unsecured
* Application Type
Individual Credit Joint Credit
* Amount Requested
* Term of Loan (In Months)
Desired Payment Date
* Proceeds of Loan to Be Used For
Referred by

Section A - Individual Applicant Information

Personal Information

* Name
* Social Security Number
* Date of Birth
* Home Phone
* Email
* Driver's License Number

Current Address

* Address Not a P.O. Box
* City
* State
* Zip
County
Years at this address
Own Rent

Previous Address

Address Not a P.O. Box
City
State
Zip
County
Years at this address

Dependent & Relative Information

Number of Dependents
Age of Dependents
Name of Nearest Relative (Not living with you)
Relationship of Relative
Relative's Address Not a P.O. Box
City
State
Zip
Phone Number

Employment Information

Current Employer

Employer's Name
Phone Number
Address
City
State
Zip
Your Position
Years at Company
Gross Salary Per Month
Net Salary Per Month

Previous Employer

Employer's Name
Phone Number
Address
City
State
Zip
Years at Company

Other Income Sources

Alimony, child support, or separate maintenance income need not be revealed if you do not wish to have it considered as a basis for repaying this obligation.

Alimony, child support, separate maintenance income received under
Court Order Written Oral Understanding None
Sources of Other Income
Amount Per Month
Is any income listed in this Section likely to be reduced before the credit request is paid off?
Yes No
Have you previously received credit from us?
Yes No

Section B - Joint Applicant or Other Party Information

Complete only if for joint credit, for individual credit relying on income or assets from other sources, or applicant is married and resides in a community property state.

Personal Information

* Co-Applicant's Name
* Social Security Number
* Date of Birth
* Home Phone
* Email
* Driver's License Number
* Relationship to Applicant (If any)

Current Address

* Co-Applicant's Address Not a P.O. Box
* City
* State
* Zip
Years at this address
Own Rent

Dependent Information

Number of Dependents
Age of Dependents

Employment Information

Current Employer

Employer's Name
Phone Number
Address
City
State
Zip
Your Position
Years at Company
Gross Salary Per Month
Net Salary Per Month

Previous Employer

Employer's Name
Phone Number
Address
City
State
Zip
Years at Company

Other Income Sources

Alimony, child support, or separate maintenance income need not be revealed if you do not wish to have it considered as a basis for repaying this obligation.

Alimony, child support, separate maintenance income received under
Court Order Written Oral Understanding None
Sources of Other Income
Amount Per Month
Is any income listed in this Section likely to be reduced before the credit request is paid off?
Yes No
Have you previously received credit from us?
Yes No

Section C - Marital Status

Complete only if: for joint or secured credit, or applicant resides in a community property state, or is relying on property located in such a state as a basis for repayment of the credit requested.

Applicant Marital Status
Married Separated Unmarried Not Applicable
Applicant Marital Status
Married Separated Unmarried Not Applicable

Section D - Asset & Debt Information

If Section B has been completed, this section should be completed giving information about both the Applicant and Joint Applicant or Other Person. If Section B was not completed, only give information about the applicant in this section.

Assets Owned

Checking Account
Applicant Co-Applicant
Savings Account
Applicant Co-Applicant
Certificate of Deposit
Applicant Co-Applicant
Marketable Securities
Applicant Co-Applicant
Real Estate
Applicant Co-Applicant
Life Insurance
Applicant Co-Applicant
Automobile
Applicant Co-Applicant
Other Assets
Applicant Co-Applicant

Outstanding Debts

Rent or Mortgage Payment
Applicant Co-Applicant
Automobile
Applicant Co-Applicant
Other Debt
Applicant Co-Applicant

Section E - Secured Credit

Complete this section only if credit is to be secured. Briefly describe the property to be given as security.

Property Description
Co-Owner Name
Co-Owner City
Co-Owner State
Co-Owner Zip
If the security is real estate, give the full name of your spouse (if any)

Section F - Credit History

Please answer the following questions for Applicant and Co-Applicant (if applicable). Please provide an explanation for Yes answers.

Applicant Credit History

HAVE YOU EVER FILED BANKRUPTCY OR HAD A DEBT ADJUSTMENT PLAN CONFIRMED UNDER CHAPTER 13?
Yes No
HAVE YOU HAD PROPERTY FORECLOSED UPON OR REPOSSESSED IN THE LAST 7 YEARS?
Yes No
ARE YOU A PARTY TO A LAWSUIT?
Yes No
ARE YOU A U.S. CITIZEN OR PERMANENT RESIDENT ALIEN?
Yes No
IS YOUR INCOME LIKELY TO DECLINE IN THE NEXT TWO YEARS?
Yes No
ARE YOU A CO-MAKER , CO-SIGNER OR GUARANTOR ON ANY LOAN LISTED ABOVE?
Yes No

Co-Applicant Credit History

HAVE YOU EVER FILED BANKRUPTCY OR HAD A DEBT ADJUSTMENT PLAN CONFIRMED UNDER CHAPTER 13?
Yes No
HAVE YOU HAD PROPERTY FORECLOSED UPON OR REPOSSESSED IN THE LAST 7 YEARS?
Yes No
ARE YOU A PARTY TO A LAWSUIT?
Yes No
ARE YOU A U.S. CITIZEN OR PERMANENT RESIDENT ALIEN?
Yes No
IS YOUR INCOME LIKELY TO DECLINE IN THE NEXT TWO YEARS?
Yes No
ARE YOU A CO-MAKER , CO-SIGNER OR GUARANTOR ON ANY LOAN LISTED ABOVE?
Yes No

By clicking Submit below, I certify that everything I have stated in this application is correct. Red River Federal Credit Union may keep this application whether or not it is approved. By submitting this application I authorize Red River Federal Credit Union to check my credit and employment history and to answer questions others may ask Red River Federal Credit Union about my credit record with Red River Federal Credit Union. I understand that I must update credit information at the request of Red River Federal Credit Union if my financial condition changes.