Membership Requirement
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Are you already a PCM Employees Credit
Union member?
Yes or No |
| If yes, your member number?
If not, please fill out the portion below regarding eligibility.... |
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I am eligible for membership through my: (see
requirements) |
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Employer |
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| Family
Member (name) |
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Loan Information
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Will there be a co-applicant on this loan
application?
Yes or No |
| Amount requested |
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| Limit requested |
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| Purpose |
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| Security |
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| Length of Loan |
See our
financial calculators... |
Personal Information
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| First Name: |
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| Middle Initial: |
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| Last Name: |
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| Social Security Number: |
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| Marital Status: |
Married
Unmarried |
| (includes single, widowed and divorced) |
| Birthdate |
(MM/DD/YYYY) |
| Home Address: |
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| City: |
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| State: |
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| Zip: |
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| How Long? |
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| Home Phone Number: |
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| If you've lived at your current address less
than 2 years, please provide your previous home address: |
| Previous Home Address: |
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| City: |
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| State: |
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| Zip: |
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| Email Address: |
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Employment Information
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| Work Phone Number: |
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| Employer name: |
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| Address: |
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| City: |
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| State: |
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| Zip: |
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| Position: |
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| Income & Asset Information |
| Gross monthly pay: |
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| Other income |
Note: Alimony, child support or separate maintenance income need not be
revealed if you do not wish to have it considered as a basis for repaying this obligation. |
| Savings/Checking balance |
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| Real Estate- locations, value |
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| Auto - year, make model |
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| Other Asset |
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| Other Asset |
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Insurance and Payment Options
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Credit Life and Credit Disability Insurance
We offer this insurance to help protect you in the future. We
encourage you to learn more about
it, but it is not required to obtain credit.I
request the following Insurance Coverage:
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| Any comments or questions you may have for us?
By submitting this application, I/We certify that this
information has been supplied truthfully, accurately and voluntarily, and therefore
authorize PCM Employees Credit Union to investigate our creditworthiness, credit history
and financial responsibility through any credit bureau or by any other reasonable means
for consideration for the loan applied for, or for any other services offered. This
application does not constitute a contract for the extension of credit.
Thank You. Upon receipt of this application, someone
at PCM Employees Credit Union will review your information and get back to you to extend
credit, with additional questions or to request further information. We appreciate
this opportunity to be your financial partner.
Notice to married applicant: No provision of a marital property agreement, a unilateral statement under Wis. Stat. sec 766.59 or a court decree under Wis Stat. sec 766.70 adversely affects the interests of the credit union unless prior to the time the credit is extended, the credit union is furnished with a copy of the agreement statement or decree, or has actual knowledge of the adverse provision when the obligation to the credit union is incurred. |
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