Carnegie Mellon F.C.U. Loan Application

 Carnegie Mellon
 Pittsburgh, PA 15213
 Fax (412) 268-1861

Print completed loan application and return to credit union by fax, campus mail, U.S. Mail, or in person.

If you are applying for Individual Credit, you must complete the Applicant section about yourself and the Co-Applicant section about your spouse if your spouse will use the account or you are relying on your spouses income as a basis of repayment. Please submit written income verification for all income sources outside of Carnegie Mellon being considered as a basis for repaying this obligation. (Outside/Part-time job. Co-Applicant earnings statement, recurring pension or Social Security payments, child support, etc.) If your applying for Joint Credit with another person, complete the Applicant and Co-Applicant sections.

AMOUNT AND TYPE OF LOAN REQUEST

Loan Amount Requested

Type of Loan

Term or Desired Payment
Monthly biweekly

Loan Purpose (for personal, emergency, and share secured loans only)

Type of Credit Individual Joint

Single Credit Life Insurance Credit Disability Insurance

APPLICANT

CO-APPLICANT

Name

Name

Address:

Address:

# Yrs. at current address

# Yrs. at current address

# Dependants
Ages

# Dependants
Ages

H. Phone

H. Phone

W. Phone

W. Phone

Date of Birth

Date of Birth

Social Security #

Social Security #

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

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

Married Separated
Unmarried (Single-Divorced-Widowed)

Married Separated
Unmarried (Single-Divorced-Widowed)

DEBTS (Applicant)

DEBTS (Co-Applicant)

Mortgage/Rent owed to

Mortgage/Rent owed to

Balance (Mortgage only)

Balance (Mortgage only)

Monthly Payment

Monthly Payment

 INCOME
 INCOME

Employer

Employer

Phone #

Phone #

Date of Hire

Date of Hire

Gross Income

Gross Income

Annual Monthly Biweekly Weekly

Annual Monthly Biweekly Weekly

Former Employer (if with current employer < 3yrs.)

Former Employer (if with current employer < 3yrs.)

Name: 

Name: 

# Yrs. Employed

# Yrs. Employed

 OTHER INCOME
 OTHER INCOME

Notice: Alimony,child support or separate maintenance income need not be revealed if you do not have it considered as a basis for repaying this obligation.

Notice: Alimony,child support or separate maintenance income need not be revealed if you do not have it considered as a basis for repaying this obligation.

Source:

Source:

$ Annual Monthly
Hourly

$ Annual Monthly
Hourly

# Yrs. employed (2nd or part-time employment)

# Yrs. employed (2nd or part-time employment)

You agree that everything stated in this application, whether written, oral, or through a FAX machine, is true and correct to the best of your knowledge. The credit union or its agent is authorized to investigate your creditworthiness, employment history, and to obtain a credit report and to answer questions about their credit history with you. You understand any false or misleading statements in your application may cause any loan to be in default. You agree that this application shall be the Credit Union's property whether or not this credit application is approved.

X _____________________________

X _____________________________

  Applicants Signature/Date
 Co-applicants Signature/Date


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