Received at:
Have you had a Salford Credit UnionLoan before? / Yes / No / Don’t know
INFORMATION ABOUT YOU
Mr / Mrs / Ms / Miss / Other / Member No.
Surname / First name
Date of Birth / National Insurance No.
Mobile No. / Home No.
YOUR ADDRESS
Current Address
Postcode
Are you a: / home owner / housing association tenant / private tenant
lodger / hostel / living with family or friends
If you are a tenant please give the name of your landlord:
How long have you lived at this address? / years / months
Number adults in your household / Ages of children in your household
Previous address
If less than 3 years at Current address
Postcode
How long did you live at this address? / years / months
Previous address
If less than 3 years at previous two addresses / Postcode
How long did you live at this address? / years / months
INFORMATION ABOUT YOUR EMPLOYMENT AND/OR BENEFITS
Are you: / employed / self-employed / unemployed / student / retired
If employed what is your occupation?
Employer’s name and address
Full time/part time / permanent/temporary/casual
How long have you worked here?
Are you in receipt of benefits or tax credits? Yes/No If yes please list your benefits on the next page
Last updated 26/5/2015Z:\Original Forms\Loan Application Form.docx
INFORMATION ABOUT YOUR INCOMEPlease make sure that you fill in ALL your income including income from pensions, tax credits or benefits. We will check these against your bank statement.
Income from wages or company pension / Income from benefits and tax credits
Type / Amount / week/fortnight/month / Name of benefit / Amount / week/fortnight/month
Net salary or wages / £ / £
Company pension / £ / £
Other / £ / £
Other / £ / £
Total Income / £ / Total Benefit Income / £
Have you included your partner’s/spouse’s income? YES/NO (if yes, they must sign this application with you)
INFORMATION ABOUT THE MONEY YOU SPEND
Please make sure you include ALL of your expenditure including any outstanding debt that you have. This will help us to see if you will be able to manage the repayments for this loan.
List here all your regular outgoings and expenses / CREDIT HISTORY
Outgoings / Amount / Week/
fortnight/month / Office Use / Please answer ALL of the following questions
Rent or Mortgage / Have you had any defaults or missed payments with your credit in the last 3 years? / Y / N
Council Tax
Water charges / Are you currently in a debt management plan or IVA? / Y / N
Gas and Electric / Have you ever been declared bankrupt? / Y / N
Insurances / Do you have any County Court Judgements (CCJs)? / Y / N
Food/Housekeeping / If you answered YES to any of these questions please give details below. Include ALL of your current debt payments.
Child care costs / Do you have any CURRENT loans or other credit / Y / N
Clothing etc. / Please list all loans, credit cards, catalogues and other credit owed
TV Rental and licence / Name of creditor / Balance owing / Payments / Wk/mth
Home/mobile Tel
Internet
Travel expenses
Car tax/ins/petrol etc.
Socialising
Other outgoings
TOTAL
Debt Repayments /
TOTAL OUTGOINGS / Sort Code - Account Number -
Further information Surplus Income £
INFORMATION ABOUT YOUR LOAN – Please answer ALL of the questions
Are you applying for a? / First Loan / Top Up Loan / Personal Loan / Secured Loan
Please ask for details of which loan is the right one for you
How much do you want to borrow? / £ / When do you need the loan?
Are you topping up an existing Loan? / Y / N
What is the reason for the loan?
Preferred repayment amount? / £
Repayment frequency? Please Circle / Weekly Fortnightly Monthly
IMPORTANT - YOUR PERSONAL INFORMATION
Credit Reference and Fraud Prevention Agencies
We may make searches about you at credit reference agencies who will supply us with credit information as well as information from the Electoral Register. The agencies will record details of any search whether or not this application proceeds. We may use credit scoring methods to assist the application and to verify your identity. Credit searches and other information which is provided to us and/or the credit reference agencies about you and anyone with whom you are linked financially or other members of your household. This information may also be used for debt tracing and the prevention of money laundering as well as the management of your account. In addition, we may ask you to provide physical forms of identification and/or we may telephone you to confirm you identity.
To prevent or detect fraud or to assist in verifying your identify we may make searches of group records and at fraud prevention agencies who will supply us with information. We may also pass information to financial and other organisation involved in fraud prevention to protect ourselves and our customers from theft and fraud. If you give us false or inaccurate information, details will be passed to fraud protection agencies.This information may also be used for tracing and claims assessments and verifying identify. Information held about you by the credit reference agencies may already be linked to records relating to anyone with whom you have a financial relationship such as a joint account.
You must be a member of Salford Credit Union to be eligible for a loan. If your loan application is successful, and you are not already a member, you must become a member of Salford Credit Union.
FORMAL DECLARATION – Your Signature
I declare that to the best of my knowledge I am in good health and fit to carry out my normal occupationand that the information I have given on this form is, to the best of my knowledge and belief, accurate and full information. I understand that the provision of false information is fraud and that the credit union may take appropriate action if I am found to have deliberately provided false or misleading information.
Applicant
Signature: / Print Name:
Date:
Partner/spouse If you have included your partner/spouse’s income they must sign below
Signature: / Print Name:
Date:
WHAT TO DO NOW – Supporting Information
You must now return this completed form to the credit union together with the following information:
- Your latest3 months bank or post office statements that include all of the income and outgoings you have declared
- Your latest Payslip or benefit statement
- Something confirming your address like your most recent utility bill, council tax letter or benefit letter
- A form of ID like your passport or driving licence
Important. Make sureyouhave completed the form fully and have all the supporting information requested otherwise your application will be delayed. In order to make a fully informed decision the loan officer looking at your application may need more information from you. If that is the case they will contact you as soon as possible. Once the loan officer is satisfied that information you have given is complete, we aim to give you a decision on your application within 5 working days.
Return your form together with supporting information to:
Salford Credit Union, 1 Loganberry Avenue, Brotherton House, Salford, M6 5UX
For enquiries: Tel: 0161 686 5880 or email:
Authorised by the Prudential Regulation Authority and regulated by the Financial Conduct Authority and the Prudential Regulation Authority.
Last updated 26/5/2015Z:\Original Forms\Loan Application Form.docx