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Secure Consumer Loan Application

This application cannot be used for mortgage loans, home improvement loans, or
home equity loans. Please contact Maria Diaz at (432) 614-8431 for these types of loans.


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Privacy Statement: Any information provided by a consumer or customer via our online forms WILL be held in the strictest confidence. No information will be shared with others. All submissions will be responded to within two business days.


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Please answer every question.
Notice: We may report information about your account to credit bureaus. Late payment and other defaults on your account may be reflected in your credit report.
Member Number:
Loan Information:
Type of Loan Applied For:
Personal (Signature)   Share Secured   New Car   Used Car   Boat   Travel Trailer/Camper   Motorcycle/ATV   Other:
Amount Applied For:
Purpose:
Desired Repayment Length (months):
Security Offered:
Year:
 
Make:
 
Model:
 
VIN #:
Applicant: Joint Applicant:
Last Name
First
MI
Last Name
First
MI
Social Security #
Birth Date (mm/dd/yyyy)
Social Security #
Birth Date (mm/dd/yyyy)
Drivers License #
State
Drivers License #
State
Present Address
Present Address
City
State
Zip
City
State
Zip
Current Address Since
If > 2 yrs, Previous Addr.
Yrs at Previous Addr.
Current Address Since
If > 2 yrs, Previous Addr.
Yrs at Previous Addr.
Home Phone
Cell Phone
Work Phone
Home Phone
Cell Phone
Work Phone
US Citizen
Yes   No
Number of Dependents Living With You
US Citizen
Yes   No
Number of Dependents Living With You
Please indicate your marital status if you are applying for joint credit, secured credit, or if you live in a community property state
Married   Separated   Unmarried (Single, Widowed, Divorced)
Please indicate your marital status if you are applying for joint credit, secured credit, or if you live in a community property state
Married   Separated   Unmarried (Single, Widowed, Divorced)
Employment and Income:
Employer Name
Employer Name
Employer Address
Employer Address
City
State
Zip
City
State
Zip
Employer Phone #
Department
Employer Phone #
Department
Supervisor
Position
Supervisor
Position
Date Hired
Monthly Gross Income
Other Monthly Income
Date Hired
Monthly Gross Income
Other Monthly Income
Previous Employer Name
Yrs Employed
Previous Employer Name
Yrs Employed
In order to expedite the processing of your loan application, please fax your 2 most recent pay stub copies to (800)886-0339 -- Attention: Loan Department. If self-employed or retired, last 2 years complete income tax returns will be needed
Note: Alimony, child support, or separate maintenance income need not be revealed if you do not choose to have it considered as a basis for this credit request.
Credit Information: Please list all accounts with a balance.
Creditor Monthly Payment Creditor Monthly Payment
Housing
Rent   Own   None   Family
Housing
Rent   Own   None   Family
 
Child Support Payment
 
Child Support Payment
Other
Other
Other
Other
Other
Other
Other
Other
Other
Other
References - 3 Nearest Relatives Not Living With Member:
Name
Name
Name
Phone #
Phone #
Phone #
Street Address
Street Address
Street Address
City
State
Zip
City
State
Zip
City
State
Zip
Relationship
Relationship
Relationship
Income and History:
Is your income likely to decline in the next 2 years? Yes   No Have you ever filed for bankruptcy or had repossession? Yes   No
Are you a cosigner on any other loan? Yes   No Are there any judgments or liens against you? Yes   No
If a yes answer is given to any of the above questions, please provide an explanation:
Married applicants may apply for a separate account. If you are applying for individual credit, you must complete the applicant section about yourself and the joint applicant section about your spouse if:
  • You live in or the property pledged as collateral is located in a community property state (AZ,CA,ID,LA,NM,NV,TX,WA,WI)
  • Your spouse will use the account or
  • You are relying on your spouse's income as a basis for repayment.
If you are applying for joint credit with another person, complete the applicant and joint applicant sections.
Payment Protection Coverage:
Check coverage(s) desired. The Credit Union will disclose the cost of this voluntary insurance to you. A separate enrollment form which disclose the terms and conditions must be signed for coverage to become effective.
Single Credit Disability/
Single Credit Life
Single Credit Disability/
Joint Credit Life
Single Credit Life Insurance Joint Credit Life Insurance Rejected
How Can We Contact You:
Home Phone #
Cell Phone #
Work Phone #
Email Address:
Best Time of Day to Contact:
Signature:
By signing this application (typing your signature below) for credit and pressing the "Submit Application" button you agree that everything stated herein is correct to the best of your knowledge. In addition, the creditors you have listed is a complete list of what you owe. If there are any changes, you will notify us in writing immediately. You authorize Southwest Heritage Credit Union to obtain credit reports in connection with this application for credit, and for any update, increase, renewal, or extension of the credit received. You understand that the Credit Union will tell you the name and address of any credit bureau from which it received a credit report on you. It is a federal crime to willfully and deliberately provide incomplete or incorrect information on loan applications made to federal or state chartered Credit Unions insured by NCUA.
We may report information about you account to credit bureaus. Late payments, missed payments or other defaults on your account may be reflected in your credit report.
Required: I have read and understood the terms of the disclosure above.
Applicant Signature Date
Joint Applicant Signature Date



Please click on the "Submit Application" button to send your application.

One of our representatives will respond to your submission as soon as possible.

   


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