LCU Logo

Web Loan Application

 

Free Auto Insurance Quote

FREE Home Insurance Quote

Note: The above links will open in a new page.

 

To apply for a loan with Leyden Credit Union, please fill out and submit the following form to us. In order to reduce processing delays, please be as complete as possible.

 

If you are not a member yet, please be sure you qualify for membership before applying for a loan with us.

 

RSA Encrypted Page This is a secure form. All of the information sent from this form is encrypted using Secure Sockets Layer (SSL). If you do not have a browser that supports SSL, DO NOT submit this form! You may use a printable loan application and mail or fax it to us.


Loan Information

Select the purpose of the loan from the following list of options. If applying for a vehicle loan, please describe the vehicle (year, make, model, downpayment amount, etc.) in the loan details box provided. If "Other" is selected, please describe the loan details below.

STOP: If you are applying for a Home Equity Loan, DO NOT USE THIS FORM. We must send you an Application Packet by mail. Please contact Leyden Credit Union by phone or by Email. Thank you.

Purpose of Loan:
Amount Requested: $
Length of Loan (term): Months (Enter 0 for a Credit Card or Line of Credit)
Loan Details & Comments:

Credit Card Applicants:


Please be sure to review our Credit Card Disclosure before proceeding.

Visa Gold Applications Only: If you do not qualify for the Visa Gold credit card, would you like to be considered for the Visa Classic credit card instead? Yes
No


Individual
Joint


Select "Individual" if this will be an Individual Application. Select "Joint" if this will be a Joint Application.


General Information

Complete previous address information if you have lived in your present home for less than two (2) years. A Co-Applicant (CoAp) is not required, but you must complete the co-applicant portion if this will be a joint application.

 

Applicant

Co-Applicant

Full Name: Full Name:
Marital Status: Marital Status:
Married Separated
Unmarried (single, divorced, widowed)
Married Separated
Unmarried (single, divorced, widowed)
LCU Acct Number: (enter 0 if none) LCU Acct Number: (enter 0 if none)
Social Security Number: Social Security Number:
- - - -
Birthdate: Birthdate:
Month: Day: Year: Month: Day: Year:
Drivers License Number: Drivers License Number:
  State:   State:
E-mail Address: E-mail Address:
Home Address: Home Address:
City, State, Zip: City, State, Zip:
, , , ,
Home Phone Number: Home Phone Number:
- - - -
Cell Phone Number: Cell Phone Number:
- - - -
Lived At This Address: Lived At This Address:
Years Years
Previous Address: Previous Address:
City, State, Zip: City, State, Zip:
, , , ,
Lived At Previous Address: Lived At Previous Address:
Years Years


Employment

Complete previous employer information if you have been at your present job for less than five (5) years.

 

Applicant

Co-Applicant

Employer Name: Employer Name:
Employer Address: Employer Address:
City, State, Zip: City, State, Zip:
, , , ,
Your Title / Position: Your Title / Position:
Supervisor Name: Supervisor Name:
Employer Phone Number: Employer Phone Number:
- - - -
Start Date: Start Date:
Month: Year: Month: Year:
Previous Employer: Previous Employer:
Previous Employer Address: Previous Employer Address:
City, State, Zip: City, State, Zip:
, , , ,
Previous Employment Start Date: Previous Employment Start Date:
Month: Year: Month: Year:
Previous Employment Stop Date: Previous Employment Stop Date:
Month: Year: Month: Year:


References

Applicant

Co-Applicant

Nearest Relative: Nearest Relative:
Relationship: Relationship:
Relative's Address: Relative's Address:
City, State, Zip: City, State, Zip:
, , , ,
Relative's Phone Number: Relative's Phone Number:
- - - -
Personal Friend: Personal Friend:
Friend's Address: Friend's Address:
City, State, Zip: City, State, Zip:
, , , ,
Friend's Phone Number: Friend's Phone Number:
- - - -


Income

      

Applicant

Co-Applicant

Employment Income: Employment Income:
$ Per
Month Year
Gross Net
$ Per
Month Year
Gross Net
Other Income: Other Income:
$ Per
Month Year
Gross Net
$ Per
Month Year
Gross Net
Source of Other Income: Source of Other Income:


Assets

List all liquid assets here and non-liquid assets below. If you have more assets than this form allows, enter your greatest assets within the spaces provided.

 

Account Type Name / Address of Depository Balance
$
Appl CoAp
$
Appl CoAp
$
Appl CoAp
$
Appl CoAp

 

List assets and account numbers (if applicable).
Examples: home, vehicle, boat, stocks, bonds, real estate, etc.

 

Asset (5): Details / Location: Market Value:
$
Appl CoAp Pledged as Collateral for another loan? Yes   No



Asset (6): Details / Location: Market Value:
$
Appl CoAp Pledged as Collateral for another loan? Yes   No



Asset (7): Details / Location: Market Value:
$
Appl CoAp Pledged as Collateral for another loan? Yes   No


Debts

In addition to Rent/Mortgage, list all other debts. For example: vehicle loan(s), credit card(s), second mortgage, home association dues, alimony, child support, child care, medical, utilities, vehicle insurance, IRS liabilities, etc.) If you have more debts than this form allows for, enter the debts with the largest monthly payment.

 

Debt (1): Debt Owner: Appl CoAp
Creditor Name: Orig. Amt: $
Creditor Address: Balance: $
Account No: Mthly Pymt: $




Debt (2): Debt Owner: Appl CoAp
Creditor Name: Orig. Amt: $
Creditor Address: Balance: $
Account No: Mthly Pymt: $




Debt (3): Debt Owner: Appl CoAp
Creditor Name: Orig. Amt: $
Creditor Address: Balance: $
Account No: Mthly Pymt: $




Debt (4): Debt Owner: Appl CoAp
Creditor Name: Orig. Amt: $
Creditor Address: Balance: $
Account No: Mthly Pymt: $




Debt (5): Debt Owner: Appl CoAp
Creditor Name: Orig. Amt: $
Creditor Address: Balance: $
Account No: Mthly Pymt: $


Financial Information

If a 'Yes' answer is given to any question, explain within the box provided below.

Appl

CoAp


Yes

No

Yes

No

1. Do you have any outstanding judgments?
2. Have you ever filed bankruptcy or chapter 13 debt consolidation?
3. Have you ever had property foreclosed upon or repossessed in the last 7 years?
4. Are you a party in a lawsuit?
5. Are you other than a U.S. citizen or resident alien?
6. Is your income likely to decline within the next two (2) years?
7. Are you a co-maker, co-signer, or guarantor on any loan not listed above?

 


If you need to clarify or comment on any information provided in this form, you may do so within the following box provided. This information will be submitted with your Loan Application request to a loan officer for review.

By submitting this form, you promise that the information shown on this application is correct to the best of your knowledge and that the above information is a complete listing of your debts and obligations. You authorize Leyden Credit Union to obtain a credit report in connection with this application for credit and for any update, renewal, or extension of the credit received. If you request, Leyden Credit Union will  tell you the name and address of any credit bureau from which we 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 Credit Unions insured by the NCUA.

VISA Credit Card Disclosure Information VISA Gold VISA Classic
Annual Percentage Rate (APR) for purchases 9.0% 13.8%
Cash Advance / Balance Transfer APRs 9.0% 13.8%
Grace Period for repayment of Purchase Balance 25 Days
Method of Computing Balances for Purchases Average Daily Balance
(including new purchases)
Annual Fee None
Minimum Finance Charge None
Returned Check Fee $25.00
Transaction Fee for Cash Advances None
Balance Transfer Fee None
Late Payment Fee $25.00
Over-the-credit-limit Fee None

 

 

 

2701 N. 25th Ave.   -   Franklin Park, IL 60131
847-455-8440   -   fax 847-455-1245

Copyright 2001 Leyden Credit Union, All rights reserved.