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Individual Application

Before filling out this application please note the following:

1. The ENTER key does not switch between fields, please use the TAB key or the mouse to scroll down.
2. If you need to go back to previous fields, please use SHIFT-TAB.
3. Fields marked with an asterisk (*) are required fields.
4. Married persons may apply for credit in their own names.
5. If not currently a member, please complete the loan application and submit it; then a member number will be assigned after processing.
6. We will have an answer for you within an hour.
7. For a Credit Card Application, click here.
8. For a Mortgage Application, click here.

If (1) another person will use this account, (2) you want a joint account, (3) you are married and live in a community property state (AZ, CA, ID, LA, NV, NM, TX, WA, WI), or (4) you are relying on the income of a spouse to repay this loan, please fill out a joint application instead of this one.

Click for HHCU's Privacy Policy.

Loan Information
Type of Loan
 Amount Requested ($100 minimum)
 Length of Loan (months)
Collateral Offered
Vehicle / Boat / Motorcycle
Make
 Model
 Year
 Mileage

Will the loan proceeds be used to purchase the collateral?

Real Estate
Address
First Mortgage Holder Current Value of Residence $
About You
Marital Status
Member Account Number
First Name*
 Initial
 Last Name*
Suffix (Jr., Sr., III, etc.)
Date of Birth* (mm/dd/yyyy)
 Social Security # / Tax ID*
 		Are you a US citizen?
Home Phone*
 Work Phone
ext 		     
Best time to call
 E-Mail Address*
Your Address
Residence Address (Do not use P O Box)
City
State
Zip
Years at this address
      
Mailing Address (if different)
 Mailing City
Mailing State
 Mailing Zip
Current Employment Information
Status
 Position / Occupation
  
Employer
 Years on Job
 Years in Occupation
Address
City
 State
 Zip
Employer's Main Phone
ext 		     
Income
Net $
Other** $
** Spousal support, child support, or separate maintenance income need not be revealed if you do not choose to have it considered for repayment of this loan.
Personal References
Name
 Address
Phone
 Relationship
Name
 Address
Phone
 Relationship
Assets
Autos Owned
Year
Make/Model
Balance
Payment
Car-1
$
$
Car-2
$
$
Car-3/RV/Boat
$
$
Home

- Rental Payment $ Live w/ Parents

1st Mortgage Balance $ Payment Amount $
2nd Mortgage Balance $ Payment Amount $
Other Debts
Creditor Balance Payment
Please answer the following questions. If you answer 'yes' to any question, please place comments in the box below along with the question number.
(1) Have you ever had a repossession?

(2) Have you ever filed bankruptcy?
(3) Are you a co-signor on any other loan?
(4) Are there any judgments or liens against you?
(5) Are there any support or maintenance awards?
Please use the space provided below for any questions/comments you may have. Also include comments for any 'yes' from above.
Are you interested in protecting your payments with credit life or disability insurance?


By clicking the 'submit' button below, I certify that:

1. I understand I must be a member in good standing to obtain a loan from my credit union.
2. That statements on this application are true and complete.
3. I authorize any person, association, firm, or corporation to furnish, on request of this credit union, information concerning me or my financial affairs.



Deposits Federally Insured by NCUA  Equal Housing Lender Visitors to our web site are advised that e-mail communications may not be wholly secure from interception. Please do not include confidential information such as social security or account numbers in your e-mail communications. For a secure way to send information, click here. Click to read Hoosier Hills Credit Union's Privacy Policy.