Huntingtonized Logo

Secure Loan Application Form

481 West 8th Ave, Huntington WV 25701
Phone: (304) 528-2400  •  Fax: (304) 528-2404
   
Type Of Loan Applying For

Married applicants may apply for a separate account. If you are applying for Individual Credit, you must complete the Applicant section about yourself and the Joint Applicant section about your spouse if:

  • Your spouse will use the account, or
  • You are relying on your spouse's income as a basis for repayment.

If you are applying for Joint Credit with another person, complete the Applicant and Joint Applicant sections.
* You Must be a Huntingtonized FCU Member to apply for a loan.

Is this your first loan from us? Yes    No

Are you applying for individual or joint credit ?: Individual    Joint
Loan Type:




Visa Disclosure
I have read and agree with Terms and Conditions

Amount Requested: $ .00       Purpose:

Security offered (for secure credit only):

Repayment Time:



Payment Protection Coverage
Check coverage(s) desired. The Credit Union will disclose the cost of this voluntary insurance to you. A separate enrollment form which discloses the terms and conditions must be signed for coverage to become effective.
Single Credit Disability       None
Single Credit Life Insurance       Joint Credit Life Insurance       None
GAP Coverage       None


Applicant Information
Applicant's Name:
Account #:
Driver License #:
Social Security #:
Email:
US Citizen: Yes No
Birthdate:
Home Phone #:
Cell Phone #:
Street Address:
City: State:
Zip #:
Monthly Housing Payment: $
Current Address since: (MM/YY)
Joint Applicant's Name:
Account #:
Driver License #:
Social Security #:
Email:
US Citizen: Yes No
Birthdate:
Home Phone #:
Cell Phone #:
Street Address:
City: State:
Zip #:
Monthly Housing Payment: $
Current Address since: (MM/YY)


Employment Information
Applicant Employer's Name:
Employer Phone #:
Employer Address:
Position:
Date Hired (MM/DD/YY):
Monthly Gross Income ($):
Other Income ($): per Month
Other Income Source:
Joint App. Employer's Name:
Employer Phone #:
Employer Address:
Position:
Date Hired (MM/DD/YY):
Monthly Gross Income ($):
Other Income ($): per Month
Other Income Source:
NOTE: Alimony, child support, or separate maintenance income need not be revealed if You do not choose to have it considered as a basis for this credit request.


Debts & Assets
Lender
Type
Balance
Min. Pmt.
$ .00
$ .00
$ .00
$ .00
$ .00
$ .00
$ .00
$ .00
$ .00
$ .00
$ .00
$ .00
$ .00
$ .00
$ .00
$ .00
$ .00
$ .00
Assets:
Description: Value:
    
Description: Value:
    
Have you ever filed for bankruptcy or had debt adjustment under Chapter 13?
   Are you a party in a lawsuit?
   Have you ever had property foreclosed or repossesion in the last 7 years?
   Is your income likely to decline in the next two years?
Are you co-maker/endorser on any loan not listed above?
   If yes then for whom?
   If yes then to whom?


References (Nearest relative not living with you)
First Name: Middle Name: Last Name: Suffix:
   Home Phone Number:
   555-555-5555
   What is their home address?
Street: City: State: Zip:
   What is the relationship?


Contact Method
  How would you prefer to be contacted? Home Phone Cell Phone Email
 
  Additional Comments:


Submit Application

You agree that everything stated in this application is correct to the best of your knowledge. The Credit Union is authorized to investigate your creditworthiness, employment history, and to obtain a credit report and to answer questions about their credit experience with you. You understand that any false or misleading statement in your application may cause any loan or extension of credit to be in default. You authorize us to accept your facsimile signatures on this application and agree that your facsimile signature will have the same legal force and effect as your original signature. You assume any risk that may be associated with permitting us to accept your facsimile signature.

By pressing the "Submit Application" button below, you agree to the above statement. You understand that we may require additional information to finalize our credit decision and your signature on additional documents prior to disbursing any credit proceeds.