Town of Cheektowaga Federal Credit Union

Loan Information
Personal Information
Co-Applicant Information

Town of Cheektowaga Loan Application

Amount Requested *

Loan Type *

Loan Term(in months) *

Acct No. (if applicable)

Repayment Method *

Cash(overcounter)

Automatic Shares Transfer

Automatic Checking Transfer

Automatic Payroll Payment

Credit Disability Insurance

Yes

Credit Life Insurance

Yes

If you answer "yes", then the credit union will disclose the cost of this voluntary insurance payment protection to you. A separate election which discloses the terms and conditions must be signed for protection to be effective.

Personal information

Applicant's name (First, M, Last) *

Social Security No. *

Driver's License *

Driver's License State

Date of Birth *

Present Address *

Years There *

Previous Address (if less than 2 years at present address)

Years There

Phone *

Email *

No. of Dependents *

Complete for joint credit, secured credit, or if you live in a community property state

Married

Separated

Unmarried (single-divorced-widowed)

Employment information

Employer *

Position *

Annual Income *

Employee Start Date *

Previous employer (if less than 2 years at present employer)

Start date

Other Income

Source

Credit information

Residence

Own

Rent

Lives with relatives

Present Mortgage Co., Landlord, Relative

Monthly Mortgage/Rent Payment (includes taxes and insurance)

Current Value

Mortgage Balance

Have you ever had a car or other personal property repossessed by a dealer or finance company, filed for bankruptcy, or been a party to a wage assignment or collection suit, or have you ever been declined on a loan application in this credit union?

Yes No

Reference

Name and address of nearest relative or friend not living with you *

Relationship *

Phone *

NOTE: IF YOU ARE FILLING THIS OUT AS A SINGLE APPLICANT YOU CAN SUBMIT THE APP NOW. YOU WILL RECEIVE AN EMAIL CONFIRMING THE APPLICATION.

Co-Applicant information

Co-Applicant's name (First, M, Last)

Social Security No.

Driver's License

Driver's License State

Date of Birth

Present Address

Years There

Previous Address (if less than 2 years at present address)

Years There

Phone

No. of Dependents

Complete for joint credit, secured credit, or if you live in a community property state

Married

Separated

Unmarried (single-divorced-widowed)

Employment information

Employer

Position

Annual Income

Employee Start Date *

Previous employer (if less than 2 years at present employer)

Start date

Other Income

Source

Credit information

Residence

Own

Rent

Lives with relatives

Present Mortgage Co., Landlord, Relative

Monthly Mortgage/Rent Payment (includes taxes and insurance)

Current Value

Mortgage Balance

Have you ever had a car or other personal property repossessed by a dealer or finacne company, filed for bankruptcy, or been a party to a wage assignment or collection suit, or have you ever been declined on a loan application in this credit union?

Yes No

Reference

Name and address of nearest relative or friend not living with you

Relationship

Phone