Secure Loan Application

Type of Loan Applying For

Select Loan Type

If other, enter type of loan

Purpose of loan/Collateral

Requested Amount ($)

Requested Term for Loan

I have read and agree with the

Applicant Information

First Name

Last Name

Account #

Social Security #

U.S. Citizen

Date of Birth

Email Address

Number of Dependents

We consider the primary borrower one dependent, a spouse would be the second dependent and then children would be subsequent dependents.

Please indicate your marital status if you are applying for joint credit, secured credit or if you live in a community property state:

Marital Status

Primary Phone

Secondary Phone

Street Address

City

State

Zip Code

Current Address since

Rent Own

Payment ($)

If less than 3 years:

Enter Previous Address

Number of months at previous address:

Number of Months

Joint Applicant Information

Is there a joint applicant for this loan?

Yes

First Name

Last Name

Account #

Social Security #

U.S. Citizen

Date of Birth

Email Address

Number of Dependents

We consider the primary borrower one dependent, a spouse would be the second dependent and then children would be subsequent dependents.

Please indicate your marital status if you are applying for joint credit, secured credit or if you live in a community property state:

Marital Status

Primary Phone

Secondary Phone

Street Address

City

State

Zip Code

Current Address since

Rent Own

Payment($)

If less than 3 years:

Enter Previous Address

Number of months at previous address:

Number of months

Employment Information

Applicant Employer's Name

Employer Phone #

Employer Address

Status

Position

Date Hired

Monthly Salary($)

Other Income/Month($)

Previous Job Start Date

Previous Job End Date

Previous Employer's Name

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.

Joint Applicant Employment Information

No Joint Applicant Selected.

References

Nearest Relative not living with you

First Name

Last Name

Suffix

Primary Phone

Home Address

City

State:

Zip Code

Relationship

Comments

Enter Additional Comments

Submit Application

READ CAREFULLY BEFORE SIGNING/ SUBMITTING. PER YOUR MEMBERSHIP AND/OR LOAN AGREEMENTS WITH JACK DANIEL EMPLOYEES’ CREDIT UNION YOU GIVE US A SECURITY INTEREST IN YOUR ACCOUNT(S) AND CERTAIN OTHER PROPERTY PLEDGED AS DESCRIBED IN SAID AGREEMENTS.

By submitting this application by facsimile or electronically, 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. If there is a co-applicant on this loan, the co-applicant has authorized the submission of this application. This facsimile or electronic submission qualifies as your signature. It is understood that you will have to sign loan documents before funds can be disbursed.

By pressing the “Submit Application” button below, you agree to the above statement.

Type of Loan Applying For

Applicant Information

Joint Applicant Information

Employment Information

Joint Applicant Employment Information

References

Nearest Relative not living with you

Comments

Submit Application

Jack Daniels Employees' CU Application and Solicitation Disclosure for VISA GOLD/ VISA PLATINUM PREFERRED/VISA PLATINUM/VISA CLASSIC

Jack Daniels Employees' CU
Application and Solicitation Disclosure
for VISA GOLD/ VISA PLATINUM PREFERRED/VISA PLATINUM/VISA CLASSIC