Loan Application

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Date

What State Do You Live In?*

OHIO RESIDENTS ONLY: The Ohio laws make credit equally available to all creditworthy customers, and that credit reporting agencies maintain separate credit histories on each individual upon request. The Ohio Rights Commission administers compliance with this law. WISCONSIN RESIDENTS ONLY: (1) No provision on any marital property agreement, unilateral statement under Section 766.59, or court decree under Section 766.70 will adversely affect the rights of the Credit Union unless the Credit Union is furnished a copy of the agreement, statement or decree, or has actual knowledge of its terms, before the credit is granted or the account is opened. (2) If you are not applying for this account or loan with your spouse, you will be asked for your signature. The credit being applied for, if granted, will be incurred in the interest of the marriage or family of the signer.

MARRIED APPLICANTS: May apply for a separate:
Individual Credit: You must complete the Applicant section about yourself and the Co-Signer section about your spouse if:
1. you live in or the property pledged as collateral is located in a community property state (AK, AZ, CA, ID, LA, NM, NV, TX, WA, WI),
2. your spouse will use the account, or
3. you are relying on your spouse's income as a basis for repayment. If you are relying on income from alimony, child support or separate maintenance, complete the Other section to the extent possible about the person on whose payments you are relying.
Joint Credit: If you are applying with another person, complete the Application and Co-Signer sections.
Guarantor:Complete the Co-Signer section if you are a guarantor on an account/loan.

Purpose/Collateral*

Preferred Lender

If you have a specific lender you are working with please enter their name.

Amount Requested:*

(Refinance) Current Lender:*

(Refinance) Current APR:*

(Refinance) Current Payment:*

(Refinance) Current Term:*

Give Description of Purpose/Collateral:*

Example: (Year/Make/Model) -- add as much detail as possible

Preferred Payment Date*

The day each month you would like to have your payment due, i.e. 1st, 5th, 20th, etc.

Are you interested in Payment Protection?*

Yes
No

The Credit Union will disclose the cost of this voluntary insurance to you. A separate insurance election which discloses the terms and conditions must be signed for coverage to become effective. If you have questions, a loan officer will give you all the information you need.

APPLICANT

Name:*

First Last

Are you a current member?*

Yes
No

Please make sure you qualify for membership. University & Community Federal Credit Union membership is open to anyone who lives, works, worships or attends school in Payne County, Lincoln County, Logan County, Noble County, and Pawnee County. Any relative of a member is also eligible for membership.

What is your account number to be used for this loan application?*

Mother's Maiden Last Name:*

Social Security Number:*

Driver's License Number/State:*

Date of Birth*

Home Phone:*

(###)###-####

Business Phone:

(###)###-####

Email:*

Enter Email Confirm Email

Address:*

Street Address City State ZIP Code

Length at Residence:*

Residence:*

Mortgage
Rent
Own

Mortgage/Rent Owed To:*

Mortgage Balance:*

Monthly Payment:*

Interest Rate:*

Marital Status:

Employment Income:*

$/per

Employer Name:*

Employer Address:*

Street Address City State ZIP Code

Employment Start Date*

Other Income:

($/per/source)
NOTICE: Retirement, Alimony, child support or separate maintenance income need not revealed if you do not choose to have it considered. Please include any relevant income that you need for qualification purposes.

Do You Have a Proof of Income?

Accepted file types: jpg, jpeg, gif, png, pdf, Max. file size: 256 MB.

Ex: (Pay stub from the last 30 days)

Do You Have a Quote From OrangeTech?

Accepted file types: jpg, jpeg, gif, png, pdf, Max. file size: 256 MB.

Ex: (An official document with price of electronics)

Would you like a Co-Signer?*

Yes
No

By adding a co-signer, this application is then intended for joint credit and both signers agree to have their individual credit pulled.

What State Does The Co-Signer Live In?*

OHIO RESIDENTS ONLY: The Ohio laws make credit equally available to all creditworthy customers, and that credit reporting agencies maintain separate credit histories on each individual upon request. The Ohio Rights Commission administers compliance with this law. WISCONSIN RESIDENTS ONLY: (1) No provision on any marital property agreement, unilateral statement under Section 766.59, or court decree under Section 766.70 will adversely affect the rights of the Credit Union unless the Credit Union is furnished a copy of the agreement, statement or decree, or has actual knowledge of its terms, before the credit is granted or the account is opened. (2) If you are not applying for this account or loan with your spouse, you will be asked for your signature. The credit being applied for, if granted, will be incurred in the interest of the marriage or family of the signer.

MARRIED APPLICANTS: May apply for a separate:
Individual Credit: You must complete the Applicant section about yourself and the Co-Signer section about your spouse if:
1. you live in or the property pledged as collateral is located in a community property state (AK, AZ, CA, ID, LA, NM, NV, TX, WA, WI),
2. your spouse will use the account, or
3. you are relying on your spouse's income as a basis for repayment. If you are relying on income from alimony, child support or separate maintenance, complete the Other section to the extent possible about the person on whose payments you are relying.
Joint Credit: If you are applying with another person, complete the Application and Co-Signer sections.
Guarantor:Complete the Co-Signer section if you are a guarantor on an account/loan.

Co-Signer Name:*

First Last

Is the Co-Signer a current member the Credit Union?*

Yes
No

Co-Signer Account Number:*

Co-Signer Mother's Maiden Last Name:*

Co-Signer Social Security Number:*

Co-Signer Driver's License Number/State:*

Co-Signer Date of Birth:*

Co-Signer Home Phone:*

(###)###-####

Co-Signer Work Phone:

(###)###-####

Co-Signer Email:*

Enter Email Confirm Email

Co-Signer Address:*

Street Address City State ZIP Code

Co-Signer Length at Residence:*

Co-Signer Residence:*

Mortgage
Rent
Own

Co-Signer Mortgage/Rent Owed To:*

Co-Signer Mortgage Balance:*

Co-Signer Monthly Payment:*

Co-Signer Interest Rate:*

Co-Signer Marital Status:*

Co-Signer Employment Income:*

$/per

Co-Signer Employer Name:*

Co-Signer Employer Address:*

Street Address City State ZIP Code

Co-Signer Employment Start Date:

Co-Signer Other Income:

($/per/source)
NOTICE: Retirement, Alimony, child support or separate maintenance income need not revealed if you do not choose to have it considered. Please include any relevant income that you need for qualification purposes.

Do you allow us to pull your credit report?*

Yes

If this application has a co-signer listed, each applicant agrees to apply for joint credit and have credit inquires pulled on all listed borrowers.

Terms of Electronic Delivery

Definitions. In this Agreement, the word “E-Statement” refers to your periodic Statement Of Account. The word “E-Disclosure,” refers to any other disclosures that we would normally provide to you in a written form that you retain. The words “you” and “your” refer to you, the member of University & Community Federal Credit Union. The words “we,” “us,” and “our,” mean University & Community Federal Credit Union. Consent to Receive Periodic Statements and Disclosures Electronically. By clicking the “Yes” button below, you agree to accept your E-Statements and E-Disclosures online. Your E-Statement includes transaction activity for all of your share accounts, which includes savings, checking, certificates, loans, etc. You further agree that we will discontinue mailing a paper statement to you and will communicate with you electronically, as necessary. You also agree to receive other disclosures online when we elect to make them available in electronic format. These include, but are not limited to, your periodic notice of billing error rights, your periodic notice of how to report errors that involve your electronic funds transfers, and year-end tax statements for dividends earned. Requesting a Paper Copy of Disclosures. You may request a paper copy of your periodic statement or any other record received electronically under this Agreement by writing to us at the address below or by contacting Member Services at (405) 743-3328. A fee of $3.00 will be charged for the paper copy. To avoid this fee, consider printing your E-Statement from your computer. Right to Withdraw Consent. You may terminate this Agreement at any time by notifying us in writing at the address below or by contacting Member Services at (405) 743-3328. There are no fees for requesting to withdraw your consent for E-Statements and E-Disclosures. However, depending on the account you have with the Credit Union, you may be charged a monthly fee to receive a paper statement. Please cancel prior to the last day of the month to receive a paper statement for that month's financial business. System Requirements. The minimum requirements to view your account statements electronically are 64 MB of RAM, 300 MHz processor, Internet Explorer 6 or higher with 128 bit encryption, and a printer if you wish to print your E-Statement/Disclosures, or the ability to store (save) your E-Statement/Disclosures electronically to your computer. Change of Internet Service Provider, E-mail Address, or Computer Equipment. If you change your e-mail address, computer equipment or Internet Service Provider (ISP) used to access or receive electronic records, you agree to notify us of the new ISP and/or address, e-mail address and/or equipment you will be using. If we change the hardware or software to communicate electronically with you and our change materially affects your ability to access or receive communications electronically, we will notify you of the changes by e-mail and provide you with a statement of your right to withdraw consent. University & Community Federal Credit Union 311 E. McElroy Stillwater, OK 74075 (405) 743-3328

Do you consent to receiving electronic delivery of E-Statements and E-Disclosures?*

Yes

Do you acknowledge that you have read and understand the disclaimers above and that everything you have stated in this application is correct to the best of your knowledge.*

Yes

Signature*

Name

This field is for validation purposes and should be left unchanged.