Cobblestone FCU Loan Application

Will this be a Single or Joint Application?*

Single Application

Joint Application

Phone (Best contact phone #) *

No dashes, spaces, or parentheses

VIN #

Make

Model

Year

Mileage

Loan Term (in months) *

Amount Requested *

Enter a value no greater than 999,999

Repayment Method

Payroll Deduction

Cash

Military Allotment

Automatic Payment

Do you want Credit Disability Insurance in connection with this loan?

Yes, I want Credit Disability Insurance

No, I do not want Credit Disability Insurance

Do you want Credit Life Insurance in connection with this loan?

Yes, I want Credit Life Insurance

No, I do not want Credit Life Insurance

Primary Applicant - Personal information

Social Security No. *

No dashes, spaces, or parentheses

Driver's License No. *

No dashes, spaces, or parentheses

Driver's License State *

Date of Birth *

Address *

Address 2

City *

State *

Zip Code *

Years There *

Previous Address (if less than 2 years at present address)

Address 2

City

State

Zip Code

Years There

No. of Dependents *

Complete for joint credit, secured credit, or if you live in a community property state *

I am Single

I am Married

I am Separated

Employment information

Current Employer *

Position *

Annual Income *

Employee Start Date *

Credit information

Residence

I own my residence

I rent my residence

I live with relatives

Present Mortgage Co., Landlord, or Relative

Monthly Mortgage/Rent Payment (includes taxes and insurance)

Current Value. If you own your home, what is the current value?

Mortgage Balance

Is the property described your principal dwelling?

Yes, the property is my principal dwelling

No, the property is not my principal dwelling

Any proceeds for a Refinanced Mortgage, Home Equity, or Home Improvement?

Yes, there are proceeds

No, there are not proceeds

Is the property described listed as the applicant's address in the "Personal Information" section?

Yes, the addresses are the same

No, the addresses are different

Other liens

Is anyone other than your spouse a part owner of your home?

Yes, there is another owner of my home

No, there is not another owner of my home

Have you ever had a car or other personal property repossessed by a dealer or finance company, filed for bankruptcy, or been a party to a wage assignment or collection suit, or have you ever been declined on a loan application with this credit union?

Yes

Reference

Name of nearest relative not living with you *

Relatives Address *

Address 2

City *

State *

Zip Code *

Relationship *

Phone *

No dashes, spaces, or parentheses

Additional Questions

Are you other than a US citizen or permanent resident alien? *

Yes, I am other than a US Citizen or permanent resident alien

No, I am not other than a US Citizen or permanent resident alien

Do you have any outstanding judgments? *

Yes, I have outstanding judgments

No, I do not have outstanding judgments

Is your income likely to decline in the next two years? *

Yes, my income is likely to decline

No, my income is not likely to decline

Are you a co-maker, co-signer, or guarantor on any loan not listed? *

Yes, I am a co-maker

No, I am not a co-maker

Have you filed for bankruptcy or had a debt adjustment plan confirmed under chapter 13? *

Yes, I have filed for bankruptcy or debt adjustment

No, I have not filed for bankruptcy or debt adjustment

Have you had property foreclosed upon or given a deed in lieu of foreclosure in the last 7 years? *

Yes, I have had property foreclosed

No, I have not had property foreclosed

Joint Applicant - Personal information

First Name*

Last Name*

Email*

Phone (Best contact phone #)*

No dashes, spaces, or parentheses

Social Security No.*

No dashes, spaces, or parentheses

Driver's License No.*

No dashes, spaces, or parentheses

Driver's License State *

Date of Birth *

Address *

Address 2

City *

State *

Zip Code *

Years There *

No. of Dependents *

Complete for joint credit, secured credit, or if you live in a community property state *

I am Single

I am Married

I am Separated

Employment information

Current Employer *

Position *

Annual Income *

Employee Start Date *

Credit information

Residence

I own my residence

I rent my residence

I live with relatives

Present Mortgage Co., Landlord, or Relative

Monthly Mortgage/Rent Payment (includes taxes and insurance)

Current Value. If you own your home, what is the current value?

Mortgage Balance

Is the property described your principal dwelling?

Yes, the property is my principal dwelling

No, the property is not my principal dwelling

Any proceeds for a Refinanced Mortgage, Home Equity, or Home Improvement?

Yes, there are proceeds

No, there are not proceeds

Is the property described listed as the applicant's address in the "Personal Information" section?

Yes, the addresses are the same

No, the addresses are different

Other liens

Is anyone other than your spouse a part owner of your home?

Yes, there is another owner of my home

No, there is not another owner of my home

Yes

Reference

Name of nearest relative not living with you *

Relatives Address *

Address 2

City *

State *

Zip Code *

Relationship *

Phone *

No dashes, spaces, or parentheses

Debt 1 original balance

Debt 1 present balance

Debt 1 monthly payment

Debt 1 Owner:

Primary Applicant is the owner of debt

Joint Applicant is the owner of debt

Debt 2 original balance

Debt 2 present balance

Debt 2 monthly payment

Debt 2 Owner:

Primary Applicant is the owner of debt

Joint Applicant is the owner of debt

Debt 3 original balance

Debt 3 present balance

Debt 3 monthly payment

Debt 3 Owner:

Primary Applicant is the owner of debt

Joint Applicant is the owner of debt

Debt 4 original balance

Debt 4 present balance

Debt 4 monthly payment

Debt 4 Owner:

Primary Applicant is the owner of debt

Joint Applicant is the owner of debt

Debt 5 original balance

Debt 5 present balance

Debt 5 monthly payment

Debt 5 Owner:

Primary Applicant is the owner of debt

Joint Applicant is the owner of debt

Debt 6 original balance

Debt 6 present balance

Debt 6 monthly payment

Debt 6 Owner:

Primary Applicant is the owner of debt

Joint Applicant is the owner of debt

Disclosure and Agreement to Terms

I hereby certify that all information contained in the application is furnished for the purpose of obtaining the loan requested herein and is true to the best of my knowledge and belief. I further certify that no consideration has passed or will pass from me, as borrower, to an endorser for his endorsement or to co-maker for his/her signature. You are authorized to check my credit and employment history and to answer questions about your credit experience with me. I have assisted the Credit Union in the preparation of this application; I have provided the Credit Union with all of the information contained therein; I hereby certify that this loan application is truthful and complete to the best of my knowledge and that I have read the entire completed application before signing same.

Do you agree with the above terms and conditions? *

Yes, I agree to the terms

No, I do not agree to the terms

Signature (type your full name) *

Date *

Co-Applicant

Do you agree with the above terms and conditions? *

Yes, I agree to the terms

No, I do not agree to the terms

Signature (type your full name) *

Date *

Cobblestone Country Federal Credit Union 2024

Cobblestone FCU Loan Application

Primary Applicant - Personal information

Employment information

Credit information

Reference

Additional Questions

Joint Applicant - Personal information

Employment information

Credit information

Reference

List Your Debts

Disclosure and Agreement to Terms