Loan Application Amount Requested (required) Requested Term of Financing (required) For what purpose? Please indicate if this is to refinance an existing debt. Applicant's RFCU Account #: Co-Applicant's RFCU Account #: Tell Us About Yourself First Name (required) Last Name (required) Your Email (required) Address: City: State: Zip Code: Date of Birth: Social Security #: Phone: Time at Address (YRS): Rent or Own?: RentOwn Monthly Payment: Employer: Length of Employment: Hours Worked Per Week: Position: Work Phone: Gross Monthly Income: Any additional information you would like us to know about you or the loan you are applying for: Tell Us About Your Co-Applicant (Complete for Joint Credit) First Name: Last Name : Email: Address: City: State: Zip Code: Date of Birth: Social Security #: Phone: Time at Address (YRS): Rent or Own?: RentOwn Monthly Payment: Employer: Hours Worked Per Week: Position: Work Phone: Gross Monthly Income: If applying for a Vehicle Loan, describe the vehicle you wish to purchase. Year: Make: Model: Serial Number: Mileage: Please Authorize This Document If there are any important changes, you will notify us in writing immediately. You also agree to notify us of any change in your name, address or employment within a reasonable time thereafter. You also promise that everything you have stated in this application is correct to the best of your knowledge and that the above information is a complete listing of all your debts and obligations. You authorize the credit union to obtain credit reports in connection with this application, for credit for any update, renewel or extension of the credit received. If you request, the credit union will tell you the name and address of any credit bureau from which it received a credit report on you. You understand that it is a federal crime to willfully and deliberately provide incomplete or incorrect information on loan applications made to Federal Credit Unions or State Chartered Credit Unions insured by the NCUA. AUTHORIZATION TO RELEASE INFORMATION I HEREBY AUTHORIZE Rome Federal Credit Union Union (the "lender") to verify my past and present employment earnings, records, bank accounts, stock holding, pensions, and social security records, and any other asset balances that are needed to process my loan application. It is understood that a photocopy of this form will also serve as authorization. Digital Signature: Co-Applicant Digital Signature:
