Erie Police Federal Credit Union Application for Loan (Unsecured/Secured) Application for Loan (Unsecured/Secured) I, __________________________________________________ hereby, apply for a loan of $________________________________ for the purpose of (explain why) _____________________________________ Amount of money requested: $ ______________________ Account # ___________________ Old loan balance, if any $ ______________________ Note # ___________________ Accrued finance charge (interest due) $ ______________________ Debt Ratio ___________________ CDI (Credit Disability Insurance) $ ______________________ Share Balance $ ___________________ Other Charges $ ______________________ Credit Union Loans $ ___________________ Total New Loan $ ______________________ Credit Union Loans $ ___________________ Signature Loan $ ___________________ To be repaid in ___________ weekly bi-weekly semi-monthly monthly installments of $__________ including/plus interest at the rate of ____________% with the first payment beginning on ________________ Collateral offered: Credit Union shares: Account #: Amount: New/Used Vehicle: Make: Year: VIN # __________________________ Other: Owner's Names: ___________________________________________________________________ Individual Credit: Applicants Signature only: Endorser, guarantor or surety (Co-signer) Name: ___________________________________________________________________ Joint Credit/Joint Applicant/Co-maker (person who will be equally liable for repayment): Name ___________________________________________________________________ Relationship to applicant, if any: ____________________________________________________ All Information in this form is confidential Member Information Full Name: _______________________________________________________________ Birthdate: _______________ SSN #:______ _________ Address: _________________________________________________ City: _____________ State: ________ Zip: _____________ Cell Phone: _________________________ Drivers Lic #: ______________________ # of Dependents (exclude self) ________ Name of nearest relative not living with you: ___________________________________ Relationship: ___________________ Address: _________________________________________________ City: _____________ State: ________ Zip: _____________ If present residence is less than 2 years: Previous address: ______________________________________________________ City: _____________ State:_______ Zip: _________ # of years there: _________ Employer Information Present Employer: _______________________________________________________________ Address: _________________________________________________ City: _____________ State: ________ Zip: _____________ Phone: _________________________ Supervisor: ___________________________________ If employed by above less than 3 years: Previous Employer:_________________________________________________ Years there: __________ Address: _________________________________________________ City: _____________ State: ________ Zip: _____________