CD & Share Secured Loan Application

* Indicates Required

• Step 1

  Membership Identification

  Membership Area *

  Beckham Blaine Caddo Canadian Cleveland Comanche Custer Grady Greer Harmon Jackson Kiowa McClain Roger Mills Tillman Washita 41 census tracts in northwest Oklahoma County (Edmond/Deer Creek area) Wilbarger County, Texas

  Relationship *

  live, work (or regularly conduct business in), worship, or attend school Family member
• Step 2

  Type of Credit Requested

  Loan Type *

  Secured Unsecured

  Loan Type is required

  Will you be applying for Individual or Joint Credit? *

  Individual Joint

  Application Type is required

  Amount Requested *

  Term of Loan *

  Desired Payment Date

  Proceeds of Loan to Be Used For *

  Referred By *
• Step 3

  Section A - Individual Applicant Information

  Primary Applicant

  First Name *

  Last Name *

  Social Security Number *

  Date of Birth *

  Home Phone Number

  Email Address *

  Driver's License Number

  Drivers License State

  Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming
• Step 4

  Section A - Individual Applicant Information

  Primary Applicant Current Address

  Address Line 1*

  Address Line 2

  City *

  State *

  Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming

  Zip *

  County

  Years at this address *

  Residence Type

  Own Rent Other

  Housing Type is required

  Previous address

  Address

  Address Line 2

  City

  State

  Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming

  Zip

  County

  Years at Address
• Step 5

  Section A - Individual Applicant Information

  Primary Applicant Dependent & Relative Information

  Dependents

  Number of Dependents

  Ages of Dependents

  Nearest Relative

  First Name *

  Last Name *

  Relationship of Relative *

  Relative's Address

  Address Line 2

  City

  State

  Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming

  Zip

  Phone Number *
• Step 6

  Section A - Individual Applicant Information

  Primary Applicant Employment Information

  Current/Most Recent Employer

  Employer Name*

  Employer Phone Number*

  Employer Address*

  City*

  State*

  Alabama Alaska Arizona Arkansas Cadivfornia Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carodivna North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carodivna South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming

  Zip*

  Your Position *

  Years at Company *

  Gross Salary (Per Month)

  Net Salary (Per Month)

  Have you worked at another job within the past 2 years?*

  Yes No

  Whether you have another previous employment is required

  Previous Employer

  Employer Name*

  Employer Phone Number*

  Employer Address*

  City*

  State*

  Alabama Alaska Arizona Arkansas Cadivfornia Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carodivna North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carodivna South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming

  Zip*

  Your Position *

  Years at Company *

  Gross Salary (Per Month)

  Net Salary (Per Month)

  Have you worked at another job within the past 2 years?*

  Yes No

  Whether you have another previous employment is required

  Previous Employer

  Employer Name*

  Employer Phone Number*

  Employer Address*

  City*

  State*

  Alabama Alaska Arizona Arkansas Cadivfornia Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carodivna North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carodivna South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming

  Zip*

  Your Position *

  Years at Company *

  Gross Salary (Per Month)

  Net Salary (Per Month)

  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
• Step 7

  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.

  Joint Applicant

  First Name *

  Last Name *

  Social Security Number *

  Date of Birth *

  Home Phone Number

  Email Address *

  Driver's License Number

  Drivers License State

  Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming
• Step 8

  Section B - Joint Applicant or Other Party Information

  Joint Applicant Current Address

  Address Line 1*

  Address Line 2

  City *

  State *

  Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming

  Zip *

  County

  Years at this address *

  Residence Type

  Own Rent Other

  Housing Type is required

  Previous address

  Address

  Address Line 2

  City

  State

  Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming

  Zip

  County

  Years at Address
• Step 9

  Section B - Joint Applicant or Other Party Information

  Dependent Information

  Number of Dependents

  Ages of Dependents
• Step 10

  Section B - Joint Applicant or Other Party Information

  Joint Applicant Employment Information

  Current/Most Recent Employer

  Employer Name*

  Employer Phone Number*

  Employer Address*

  City*

  State*

  Alabama Alaska Arizona Arkansas Cadivfornia Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carodivna North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carodivna South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming

  Zip*

  Your Position *

  Years at Company *

  Gross Salary (Per Month)

  Net Salary (Per Month)

  Have you worked at another job within the past 2 years?*

  Yes No

  Whether you have another previous employment is required

  Previous Employer

  Employer Name*

  Employer Phone Number*

  Employer Address*

  City*

  State*

  Alabama Alaska Arizona Arkansas Cadivfornia Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carodivna North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carodivna South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming

  Zip*

  Your Position *

  Years at Company *

  Gross Salary (Per Month)

  Net Salary (Per Month)

  Have you worked at another job within the past 2 years?*

  Yes No

  Whether you have another previous employment is required

  Previous Employer

  Employer Name*

  Employer Phone Number*

  Employer Address*

  City*

  State*

  Alabama Alaska Arizona Arkansas Cadivfornia Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carodivna North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carodivna South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming

  Zip*

  Your Position *

  Years at Company *

  Gross Salary (Per Month)

  Net Salary (Per Month)

  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
• Step 11

  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 Unmarried Separated Not Applicable

  Marital Status is required

  Joint Applicant Marital Status

  Married Unmarried Separated Not Applicable

  Marital Status is required
• Step 12

  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
• Step 13

  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

  Alabama Alaska Arizona Arkansas Cadivfornia Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carodivna North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carodivna South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming

  Co-Owner Zip

  If the security is real estate, give the full name of your spouse
• Step 14

  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 EVER FILED BANKRUPTCY OR HAD A DEBT ADJUSTMENT PLAN CONFIRMED UNDER CHAPTER 13? is required

  Explain: *

  HAVE YOU HAD PROPERTY FORECLOSED UPON OR REPOSSESSED IN THE LAST 7 YEARS? *

  Yes No

  HAVE YOU HAD PROPERTY FORECLOSED UPON OR REPOSSESSED IN THE LAST 7 YEARS? is required

  Explain: *

  ARE YOU A PARTY TO A LAWSUIT? *

  Yes No

  ARE YOU A PARTY TO A LAWSUIT? is required

  Explain: *

  IS YOUR INCOME LIKELY TO DECLINE IN THE NEXT TWO YEARS? *

  Yes No

  IS YOUR INCOME LIKELY TO DECLINE IN THE NEXT TWO YEARS? is required

  Explain: *

  ARE YOU A CO-MAKER , CO-SIGNER OR GUARANTOR ON ANY LOAN LISTED ABOVE? *

  Yes No

  ARE YOU A CO-MAKER , CO-SIGNER OR GUARANTOR ON ANY LOAN LISTED ABOVE? is required

  Explain: *

  Co-Applicant Credit History

  HAVE YOU EVER FILED BANKRUPTCY OR HAD A DEBT ADJUSTMENT PLAN CONFIRMED UNDER CHAPTER 13? *

  Yes No

  HAVE YOU EVER FILED BANKRUPTCY OR HAD A DEBT ADJUSTMENT PLAN CONFIRMED UNDER CHAPTER 13? is required

  Explain: *

  HAVE YOU HAD PROPERTY FORECLOSED UPON OR REPOSSESSED IN THE LAST 7 YEARS? *

  Yes No

  HAVE YOU HAD PROPERTY FORECLOSED UPON OR REPOSSESSED IN THE LAST 7 YEARS? is required

  Explain: *

  ARE YOU A PARTY TO A LAWSUIT? *

  Yes No

  ARE YOU A PARTY TO A LAWSUIT? is required

  Explain: *

  IS YOUR INCOME LIKELY TO DECLINE IN THE NEXT TWO YEARS? *

  Yes No

  IS YOUR INCOME LIKELY TO DECLINE IN THE NEXT TWO YEARS? is required

  Explain: *

  ARE YOU A CO-MAKER , CO-SIGNER OR GUARANTOR ON ANY LOAN LISTED ABOVE? *

  Yes No

  ARE YOU A CO-MAKER , CO-SIGNER OR GUARANTOR ON ANY LOAN LISTED ABOVE? is required

  Explain: *

  By clicking Submit, 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.