LOAN APPLICATION
Loan Type Loan Amount Requested
2048 Tobacco Road
Gracewood GA, 30812

How long do you want to finance the loan?
How do you want to repay the loan?


Do you want to insure this loan with optional credit insurance?

Yes single credit disability at $2.00 per $1,000.00 of loan balance per month.
Yes single credit life at 70 cents per $1,000.00 of loan balance per month.
Yes joint credit life at $1.05 per $1,000.00 of loan balance per month.
No

Applicant Information
 
Name
Account Number
Driver's License No.
Social Security No.
Birthdate
Residence Address
Home Phone
City
State     Zip
 
Business Phone
Time at Residence
Buying/Own Rent Other  
 

Employment Information (Applicant)
Employer
Position
Length of Employment
Employer Address
City
State     Zip
 
Employer Phone
Gross Salary
Weekly     Semi-monthly Bi-weekly Monthly
Other Gross Monthly Income
Source of Other Income
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 received under:
court order written agreement oral understanding

Co-Applicant Information
Name
Account Number
Social Security No.
Residence Address
Birthdate
City
State     Zip
 
Home Phone
Time at Residence
Buying/Own Rent Other Monthly Payment

Employment Information (Co-Applicant)
Employer
Position
Length of Employment
Employer Address
City
State     Zip
 
Employer Phone
Gross Salary
Weekly     Semi-monthly Bi-weekly Monthly
Other Gross Monthly Income
Source of Other Income
 

OUTSTANDING DEBTS AND OBLIGATIONS (If a requried field does not apply to you type N/A)
Be sure to list all open accounts with a balance, include child support, alimony and IRS obligations, etc.

A = APPLICANT
C = CO-APPLICANT
     
INDICATE CODE
A or  C
LIST ALL REGULAR MONTHLY DEBTS OWED BALANCE MONTHLY PAYMENTS
You promise that everything you have stated in this application is correct to the best of you knowledge. If there are any important changes, you will notify us in writing immediately. You authorize the credit union to obtain credit reports in connection with this application for credit and any update, renewal or extension of the credit received. You understand that the Credit Union will rely on the information in this application and your credit report to make its decision. If you request, the Credit Union will tell you the name and address of any credit bureau from which it received a credit report on you. It is a federal crime to willfully and deliberately provide incomplete or incorrect information on loan applications made to federal credit unions or state chartered credit unions insured by NCUA.

   _______________________________
   Signature

   ________________
   Date
After completion print and give to CU representative.
Fax to 706-790-6733 or mail to the address above:


By submitting this application, you authorize Richmond Community Federal Credit Union to gather whatever credit and employment information considered appropriate, including information from various credit reporting agencies.

A representative from Richmond Community FCU will call you within one business day of the date the application is received.

You Must Print, Sign, and Return to Credit Union
(by mail, fax, or in person)
A signature is needed to complete the process

 
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Look under File menu, Click on Page Setup, then change margins to 0.2"