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Yes
No
Member Number
TRN
Select Loan Type *
--- Select ---
Interest Rate
Loan Amount Requested: *
Purchase Price if Applicable:
Months
--- Select ---
12 Months
24 Months
36 Months
48 Months
60 Months
72 Months
Loan Purpose
Describe Collateral
Monthly Payment
Name *
Date of Birth *
Email Address *
Home Phone Number *
Home Address *
Years at Residence *
Rent/Own *
--- Select ---
Rent
Buying
Own
Monthly Rent (if applicable)
Previous Address
Authorize Credit Report
Yes
No
Joint Applicant
Yes
No
Previous Joint Applicant *
Name *
Date of Birth *
Email Address *
Home Phone Number *
Home Address *
Years at Residence *
Rent/Own *
--- Select ---
Rent
Buying
Own
Monthly Rent (if applicable)
Previous Address
Authorize Credit Report
Yes
No
Current Employer
Title or Position
Business Phone Number
Start Date
Monthly Salary
Other Monthly Income
Source of Other Income
How many years at this Job?
Current Employer
Title or Position
Business Phone Number
Start Date
Monthly Salary
Other Monthly Income
Source of Other Income
How many years at this Job?
Credit Union Accounts
Value
Enter Your Additional Assets
--- Select ---
Credit Union Shares / Deposit
Bank / UTC Savings
Real Estate
Insurance Policy C.S.V
Household Furniture / Equip
Other
+ Add Additional Assets
Debt Information
Credit Bureau Debts
Balance
Monthly Payments
Paid Off
Credit Union Loans
Balance
Monthly Payments
Paid Off
Name of Institution
Balance
Monthly Payments
+ Add Additional Debts
Join Member Section
Credit Bureau Debts
Balance
Monthly Payments
Paid Off
Name of Institution
Balance
Monthly Payments
+ Add Additional Debts
Name
Home Phone
Home Address
Relationship
Name
Home Phone
Home Address
Relationship
Loan Information
Edit
Loan Type:
Desired Loan Amount:
Purchase Price
Loan Purpose:
Repayment Term:
Collateral:
Monthly Payment:
Applicant
Edit
Name:
Address:
TRN:
Date of Birth:
Home Phone:
Email Address:
Years at Residence:
Rent/Own:
Monthly Rent:
Monthly Property Taxes:
Estimated Home Value:
Previous Address:
Joint Applicant
Edit
Name:
Address:
TRN:
Date of Birth:
Home Phone:
Email Address:
Years at Residence:
Rent/Own:
Monthly Rent:
Monthly Property Taxes:
Estimated Home Value:
Previous Address:
Employment
Edit
Employer:
Position:
Business Phone Number:
Start Date:
Years at Job:
Monthly Salary:
Other Monthly Income:
Other Monthly Income Source:
Joint Employment
Edit
Employer:
Position:
Business Phone Number:
Start Date:
Years at Job:
Monthly Salary:
Other Monthly Income:
Other Monthly Income Source:
Debts
Edit
Review Member Section
Credit Bureau Debts
Balance
Monthly Payments
Paid Off
Credit Union Loans
Balance
Monthly Payments
Creditor
Balance
Monthly Payment
Review Joint Member
Credit Bureau Debts
Balance
Monthly Payments
Paid Off
Creditor
Balance
Monthly Payment
References
Edit
Full Name:
Home Phone:
Address:
Relationship
Full Name:
Home Phone:
Address:
Relationship
You have successfully submitted your application.
Please email all your supporting documents for the processing of your loan application to
loans@lascellescreditunion.com
.
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