Loan Application Member # First Name MI Last Name Address City ZIP Requested Amount $ Purpose of Loan Home Phone Mobile Phone Work Phone () -Second partThird part () -Second partThird part () -Second partThird part Best number to call Best time to call Please Choose Home Mobile Work Please Choose 8-10 a.m. 10-12 a.m. 12-2 p.m. 2-4 p.m. Email Address Please enter the security code below. I understand for a loan application to be processed I must be a member in good standing with the credit union and not be under Bankruptcy court proceedings. I authorize the Credit Union to obtain credit reports in connection with this application for credit (if applicable) and for any update, renewal or extension of the credit received. Everything that I have stated in this application is correct to the best of my knowledge. I understand that it may be a federal crime punishable by fine or imprisonment, or both, to knowingly make any false statements concerning any of the above facts as applicable under the provisions of the United States Criminal Code.