Prairie Federal Credit Union


	Loan Application
	click here for membership application

		Loan information...
Amount requested:
Purpose of loan:
Collateral to be used:
Collateral to be used:

		Applicant's Information...
First Name:
Last Name:
Current address:
City/State/Zip:
Date of birth/E-mail:
Home phone/ Work phone:
Employer:
Gross Monthly Income:
Number of Years at Job:

		Co-applicant's Information...
First Name:
Last Name:
Current address:
City/State/Zip:
Date of birth/E-mail:
Home phone/ Work phone:
Employer:
Gross Monthly Income:
Number of Years at Job:


		Alimony, child support, or separate maintenance income need not be listed unless you choose to have such income considered regarding extention and repayment of the credit request. Debt Information...
		In addition to Rent/Mortgage list all other debts (for example, auto loans, credit cards, second mortgage, home association dues, alimony, child support, or child care). Please use a separate line for each credit card and auto loan.

Applicant and Co-applicant
		Loan 1
		Loan 2
		Loan 3
		Loan 4
		Loan 5
		Loan 6
		Loan 7
		Loan 8

		You promise that everything you have stated in this application is correct to the best of your knowledge and that the above information is a complete listing of all your debts and obligations. You authorize the Credit Union to check your credit, employment history, obtain a credit report and to answer questions about their credit experience with you. Prairie Federal Credit Union will retain this application whether or not the requested credit is granted. It is a federal offense for a person to knowingly make a false statement for the purpose of influencing the action of a Federal Credit Union.