APPLICATION FOR CREDIT
PLEASE NOTICE: THIS CREDIT UNION COMPLIES WITH THE EQUAL CREDIT OPPORTUNITY ACT :

Application Date ________________Amt. Requested_________________
Member Acct. No. _______________Reason for Credit Request___________________

Information on Borrower
First Name______________Middle________ Last Name____________________________
Birth Date ______________Social Security No___________________Phone Number_____________________
E-Mail Address________________________
Residence Address_________________________________ City______________ State____ Zip_________ How Long_______
Employer’s Name_______________________ Position___________________Time at Job years_______ months________
Employer’s Phone______________________
Gross Monthly Income: $_____________________ Is there a co-applicant: Yes_____ No______
Other Monthly Income: $ ____________________Source of Other Monthly Income__________________________

Information on Co-Borrower 
First Name____________ Middle _________Last Name____________________________
Birth Date ______________Social Security No___________________Phone Number_____________________
E-Mail Address________________________
Residence Address_________________________________ City______________ State____ Zip_________ How Long_______
Employer’s Name_______________________ Position___________________Time at Job years_______ months________
Employer’s Phone______________________
Gross Monthly Income: $_____________________ Is there a co-applicant: Yes_____ No______
Other Monthly Income: $ ____________________Source of Other Monthly Income__________________________

Nearest Relative Not Living With You
Name _______________________________Phone No____________________________
Complete Address_________________________________________________________
Relationship_________________

Make of Auto:
      Year/Model           If financed, by whom     Value           Balance         Payment
1.____________    _________________   ________   __________   _________
2.____________    _________________   ________   __________   _________

Home: [ ] Own [ ] Buying [ ] Rent
Landlord or Mortgage holder________________________________
Value: ____________________Balance: ___________________Mo. Payment______________

Debts: (Include credit cards, child support, medical, or other monthly installment payments)
Creditor                             Present Balance   Monthly Payment
__________________   ___________   ________
__________________   ___________   ________
__________________   ___________   ________
__________________   ___________   ________

Declarations: In submitting this form, I/We certify that the above information is, to the best of our knowledge, true, complete and correct and is made for the purpose of obtaining credit. I/We also understand that I/We may loose our property (if this is a secured loan), if we do not make repayments as agreed on the loan document that may be executed in conjunction with this loan application. Indiana Lakes Federal Credit Union, (ILFCU) may obtain verification from any source named in the application and from third parties such as credit bureaus. ILFCU will retain the original copy of this application, even if the loan is denied or not closed for any reason. I/We authorize ILFCU to make credit investigations necessary to the judicious underwriting of the loan request and to answer valid requests regarding their credit experience with me/us. I/We also agree to update any information provided to ILFCU, and to inform ILFCU in writing of any material changes affecting our name, address, credit and employment. I/We fully understand that it is 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 Title 18 USC Sec. 1014. If this is an application of a joint account, these statements apply to all joint applicants.
Borrower Signature__________________ Date__________ Co-Borrower Signature__________________ Date_________