Pompano Beach City Employee CU Secure Quick Cash Loan Application

Application fee is $45.00 whether denied or approved. Fee must be paid separately.

Member Name:

Amount Requested up to $3,000:

Account Number:

SSN:

D.O.B.:

Current Phone:

Email Address:

Current Address:

City, State:

Employer Name:

Employer Phone:

Hire Date:

Supervisor's Name:

Part Time or Full Time?

Are you interested in having your loan protected?

Yes No

Are you currently on work probation?

Yes No

Have you filed for bankruptcy in the last five years?

Yes No

REFERENCES

Name:

Phone #:

Home Address of Relative:

PLEASE READ BELOW

I understand that my payments must be payroll/ACH deducted.
I further understand that if I am terminated or leave employment this loan must be paid in full.
Due to the nature of this loan of no credit inquiries, this loan cannot be included in Bankruptcy.
The credit union has authority to take all available account funds to pay off the loan. I also understand that I must be in good employment Status.
The above information entered by me is true and correct.

By submitting this request, you agree to the conditions and limitations above.