Loan Application Form

Personal Information

*First Name

*Last Name

*Date of Birth

Address

*Email

*Phone Number

*Query

Number of Dependents

Ages of Dependents

Employment Information

*Employer Name

*Job Title

*Monthly Income

Loan Information

*Loan Amount Requested

*Purpose of Loan

*Desired Loan Term

Emergency Contact 1

*First Name

*Last Name

*Phone Number

*Address

*Relationship

Emergency Contact 2

*First Name

*Last Name

*Phone Number

*Address

*Relationship

My Normal Monthly Expenses

Box Hand

Cable

Cellular Phone

Church Tithe

Clothing

Credit Card Payment

Electricity (Utility)

Entertainment

Groceries

Gym membership

Health insurance

Hire purchase payments

House insurance

Internet

Life insurance

Loan payments

Mortgage

Personal care

Property tax

Rent

Savings

School Fees

Telephone (Utility)

Vehicle insurance

Vehicle maintenance

Vehicle petrol

Water (Utility)

Other (State)

Other

Total Expenses = 0

My Assets

Savings at SJCCU

Savings at any other Institution: [Enter Institution Name]

Savings Amount

Savings at any other Institution: [Enter Institution Name 2] (If Applicable)

Savings Amount 2 (if Applicable)

Property

Land

Life Insurance [Cash Surrender Value]

Motor Vehicle

Other (State)

Total Assets = 0

My Liabilities

Credit Card at [Enter institution name]

Credit Card [Estimated Balance]

Credit Card [Monthly Payments]

Mortgage at [Enter institution name]

Mortgage [Estimated Balance]

Mortgage [Monthly Payments]

Loan at [Enter institution name]

Loan [Estimated Balance]

Loan [Monthly Payments]

Hire Purchase e.g. Courts, Gigi. [Estimated Balance]

Hire Purchase e.g. Courts, Gigi. [Monthly Payments]

FastCash/Axcel/AdvanceC’bean [Estimated Balance]

FastCash/Axcel/AdvanceC’bean [Monthly Payments]

Other (Indicate) [Estimated Balance]

Other (Indicate) [Monthly Payments]

Total Liabilities (Estimated Balance) = 0

Total Liabilities (Monthly Payments) = 0

Upload Your Supporting Documents

* Attach Proof of Income (Job Letter)Accepted files: PDF or Photo of your Job Letter

* Attach Proof of Address (Utility Bill)Accepted files: PDF or Photo of your Utility Bill

Do you have a Co-Borrower/Guarantor?

Authorization for credit check

*By checking the box below, I hereby authorize the St. John's Co-operative Credit Union to obtain and review my credit report and other relevant credit information from credit reporting agencies and other third parties as necessary to process my loan application. I understand that this inquiry is conducted to evaluate my creditworthiness and eligibility for the requested loan

I authorize

*I understand that providing false information may result in denial of this loan application.

I understand