Loans Application

Section 1 - Applicant / Co-Applicant Contact Information:

Are you a Porcupine Credit Union Member?

Yes No

Member
Number


(Account # if applicable)

First Name

Last Name

Birth Date


(mm-dd-yyyy)

S.I.N.


(000-000-000)

Address

City/Town

 

Postal Code

 

   

Phone Number


(ie: 306-123-4567)

Work Number


(ie: 306-123-4567)

Email-Address

Fax Number


(ie: 306-123-4567)

       

Enter Co-Applicant Information (only if you are applying for a joint loan)

First Name

Last Name

S.I.N.


(000-000-000)

Birth Date


(mm-dd-yyyy)

Section 2 — Purpose Of Loan:

(If you would like to speak to us in person, please contact our Loans Dept. at (306) 278-2181

RRSP Loan

Vehicle/RV Purchase

 

Consumer Loan

Line of Credit

 

Access Line of Credit (revolving loan)

Student Loan

 

Credit Card

 

 

 

Other

If Other Specify:

 
 

Estimated Cost of Purchase

$

   

Less Cash down or Trade in

$

   

Total Loan Amount

$

   

Repayment Term

   

Do you want Life Insurance?

   

Do you want Disability Insurance?

   

Section 3 — Employment Information:

 (A) Applicant: Occupation
Name Of Employer(s):
# of Years Employed
Gross Annual Income
Other Income (Source)
(B) Co-Applicant: Occupation
Name Of Employer(s):
# of Years Employed
Gross Annual Income
Other Income (Source)

Section 4 — Credit Information:

Type of Credit

Name of Creditor (Specify)

Payment Amount (monthly)

Balance Owing

Rent

 

Mortgage

Loan(s) / Credit Cards

Loan(s) / Credit Cards

Loan(s) / Credit Cards

Loan(s) / Credit Cards

Loan(s) / Credit Cards

Section 5 — Authorization

You will be contacted by a Loans Officer within 24 hours or the next business day.

Please Contact Me At:




Home
Work
Email
Other

Specify:

     

Comments or Questions:

 

I/we hereby make application with Porcupine Credit Union Limited (hereinafter referred to as the Credit Union) and certify that the information I/we have provided is correct and complete. I/we agree that by completing and submitting this application that I/we have received notice in writing and consent to the Credit Union obtaining, providing or exchanging such information about me/us as the Credit Union may require from time to time, (a) from and with any credit reporting agency, personal information agent, and any other credit grantor, and (b) from your employer(s) or any other person in connection with any account or loans I/we apply for.

By typing your name(s) in the authorization field(s) below, and then selecting the "Submit Loan Application" button, I/we agree to all of the foregoing including authorizing the use of my/our personal information by the Credit Union as set out above.

Applicant's Authorization

Co-Applicant's Authorization

 

 

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