Loan Amount $ / Term / q Automatic Payment from WCU Account (1/2% discount)Year /
Make
/ Model / Mileage / Selling Price $Trade-in payoff to be included in loan proceeds: $
(name of financial institution) / q GAP Insurance
q Credit Life
q Credit Disability
Borrower /
Co-Borrower
Name / NameDate of Birth
/ / / Social Security No. / Date of Birth
/ / / Social Security No.
Address / Years There / Address / Years There
City/State Zip / Phone / City/State Zip / Phone
Previous Address
(if less than 2 years at current address) / Years There / Previous Address
(if less than 2 years at current address) / Years There
Current Employer / Years There / Current Employer / Years There
Phone / Gross Monthly Income / Phone / Gross Monthly Income
Previous Employer
(if less than 2 years at current employer) / Years There / Previous Employer
(if less than 2 years at current employer) / Years There
Other Income Source* / Amount $ / Other Income Source* / Amount $
Housing Information (Borrower & Co-Borrower)
Borrower: q Rent q Own q Other ______
Co-Borrower: q Rent q Own q Other ______/ Rent/Mortgage Payment $ ______per______
Rent/Mortgage Payment $ ______per______
I/We certify that all statements made in this application are true and correct to the best of my/our knowledge. I/We authorize
you to obtain such information as you may require concerning the statements made in this application and agree that this
application shall remain the property of the Lender whether or not the loan is granted. (*You are not required to reveal income
from child support, alimony or separate maintenance payments to be considered as a basis for repaying this loan)
(x) ______/ ______/ (x) ______/ ______
Borrower / Date / Co-Borrower / Date