Online Loan Application

APPLICATION FORM

General Information

Amount: $Purpose of Loan:
Security Offered:
Applicant Information
Member #:
If you are not a member, how did you find out about our credit union?:
First Name: Middle Initial:
Last Name:
Driver's License #:
Date of Birth (dd/mm/yyyy):  /   / 
Marital Status: Tel #:
How many dependents:
Co-Applicant Information
Member #:
First Name: Middle Initial:
Last Name:
Driver's License #:
Date of Birth (dd/mm/yyyy):  /   / 
Marital Status #: Tel #:
Home Address
No. Street:  City/Town:
Province: Postal Code:
Length of Time at Current Address: Land Lord:
Previous Address
No. Street:  City/Town:
Province: Postal Code:
Length of TIme at Prev Address: Land Lord:
Applicant Employment Information
Current Employer:
How Long?:yrs.  mos.
Company Name:
Address: Tel. #:
Occupation:
Annual Gross: $ Pay Frequency:
Previous Employer (if less than 2yrs w/ current):
How Long?:yrs.  mos.
Company Name:
Other Income (Source & Amount):
Spouse / Co-Applicants Employment Information
Current Employer:
How Long?:yrs.  mos.
Company Name:
Address: Tel. #:
Occupation:
Annual Gross: $ Pay Frequency:
Previous Employer (if less than 2yrs w/ current):
How Long?:yrs.  mos.
Company Name:
Other Income (Source & Amount):
Personal Statement of Net Worth
N.B. Joint Statement of husband and wife to be supported by acceptable financial statements and income tax returns if required.
Assets
Real Estate: $
Investments - Stocks, Bonds, Ins. C.S.V.: $
Vehicle1 - Depreciated Value: $   Make:  Model:  Year:
Vehicle2 - Depreciated Value: $   Make:  Model:  Year:
Household and Personal Effects: $
Chequing Account(s): $
Location:
Savings and Certificates: $
Location:
R.R.S.P.: $
Location:
Other Assets Value($) and Description:
Liabilities
All Present Mortgages / Rent: $   Matures: (mo/yr)
All Present Mortgages / Rent: $   Matures: (mo/yr)
Loans: $   Matures: (mo/yr)
Location:
Charge Cards: $
Location:
Child Support / Alimony : $
Other: $   Description:
Other: $   Description:
Personal Reference
Reference One:
Name: Occupation:
Address: City:
Postal Code: Tel.#:
Relation:
Reference Two:
Name: Occupation:
Address: City:
Postal Code: Tel.#:
Relation:

Where Osuuspankki should contact you:
Please enter your e-mail address:
Please read and check:
 I / We hereby acknowledge notice from the Credit Union that a consumer report containing credit information is being or may be referred to in connection with the credit hereby applied for any renewal or extension thereof.
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