Please ensure that all fields marked
*
are completed.
*
name:
*
address
:
*
tel:
*
email:
*
Loan Amount Required:
*
Date Required:
*
Purpose:
Marital Status:
Dependants:
Residential Status:
How Long:
Employers Name:
Employers Address:
Occupation:
How Long:
Self Employed:
No. of Employees:
Spouse's Name:
Occupation:
Employers Name:
Employers Address:
Borrowings
Present Financial Situation
Name:
Amount:
Monthly:
Final:
Outstanding:
Repayments:
Payment Date:
Other C.U's:
Mortgage:
Bank Loan:
Overdraft:
Credit Cards:
Other:
Regular Income:
Weekly/Monthly Income (After Tax and Insurance)
Self:
Spouse:
Bank Details:
Name of Bank:
Time with Bank:
Declarations:
I/We authorise the Credit Union to make whatever enquiries are deemed necessary to process this application
Yes
No
I/We am in good health and fit to follow normal occupation.
Yes
No
I/We am not indebted to any other Credit Union, Bank or loan agency either as a borrower or guarantor except as stated above, the statements herein are made for the purpose of obtaining the loan and are true to the best of my knowledge and belief.
Yes
No
Repayment Protection Insurance
Repayment protection insurance is a cost efficient policy which meets your loans repayments for a specified period of time – if you are forced out of work through accident, sickness or redundancy.
If you want to receive further information on this service please tick the box
Terms and Conditions Apply
Loans 9% A.P.R.
