1 4600 Silver Hill Road Room 1K250 . Washington, 20233. CREDIT LINE ACCOUNT. (301) 763-0287 FAX (301) 735-8367. (800) 343-6788. AND PERSONAL LOAN APPLICATION. ACCOUNT NUMBER - APPLICANT ACCOUNT NUMBER - CO-APPLICANT DATE. Applicant Information PRINT OR TYPE ALL INFORMATION Co-Applicant Information 1. If You live in a community property state, are You: 5. Complete Co-Applicant Information only if: a. This is for a joint account w ith a Co-Applicant. Married Separated Unmarried (Includes Single, Divorced and Widow ed). b. Your Spouse w ill use Your Account. 2. Married applicants can apply for an individual loan. Indicate if You w ant an: c. You are relying on Your Spouse' s income as a source of repayment for the credit requested. d. You live in a community property state: Arizona, California, Idaho, Louisiana, Individual Loan Joint Credit w ith another Applicant Nevada, New Mexico, Texas, Washington, Wisconsin (and Puerto Rico). 3. Method of Payment: Payroll Deduction Automatic Share Transfer Cash Payment ACH 6.
2 Definitions: Whenever used in this application, the w ords " You" and " Your" refer to the Applicant(s). 4. Frequency of Payment: Weekly Bi-Weekly Semi-Monthly Monthly or Spouse/Co-Applicant and the w ords " We" , " Us" , and " Our" refer to the Lender. Lines of Credit Applied For: Closed-End Loans Applied For: Redi-Cash Line-of-Credit - Limit Desired $ _____ Secured Unsecured Share Secured No. of Mont hs _____. Overdraft Protection: Yes No $_____ $_____ $_____. Purpose _____. Premier Line-of-Credit - Limit Desired $ _____. Collat eral Of f ered _____. Overdraft Protection: Yes No Collat eral Ow ned By _____. Purpose _____ _____. APPLICANT CO-APPLICANT. FIRST NAME/INITIAL/LAST NAME FIRST NAME/INITIAL/LAST NAME. SOCIAL SECURITY NUMBER BIRTHDATE SOCIAL SECURITY NUMBER BIRTHDATE. CURRENT STREET ADDRESS APT. NO. SINCE (MO. YR.) CURRENT STREET ADDRESS APT. NO. SINCE (MO. YR.). CITY STATE ZIP CITY STATE ZIP. COUNTY TOWNSHIP COUNTY TOWNSHIP. FORMER ADDRESS (COMPLETE IF PREVIOUS ADDRESS IS LESS THAN 3 YEARS) YEARS THERE FORMER ADDRESS (COMPLETE IF PREVIOUS ADDRESS IS LESS THAN 3 YEARS) YEARS THERE.
3 DO YOU: HOME TELEPHONE NO. OF DEP. AGES OF DEPENDENTS DO YOU: HOME TELEPHONE NO. OF DEP. AGES OF DEPENDENTS. OWN RENT PAY BOARD OWN RENT PAY BOARD. NAME, ADDRESS AND TELEPHONE OF NEAREST RELATIVE NOT LIVING WITH YOU NAME, ADDRESS AND TELEPHONE OF NEAREST RELATIVE NOT LIVING WITH YOU. EMPLOYMENT AND INCOME If self-employed or retired, attach financial statement or income tax returns. CURRENT EMPLOYER (INCLUDE EMPLOYEE IF APPLICABLE) EMPLOYMENT DATE CURRENT EMPLOYER (INCLUDE EMPLOYEE IF APPLICABLE) EMPLOYMENT DATE. ADDRESS/CITY/STATE/ZIP ADDRESS/CITY/STATE/ZIP. WORK TELEPHONE POSITION MO. GROSS INCOME WORK TELEPHONE POSITION MO. GROSS INCOME. $ $. FORMER EMPLOYER POSITION YEARS THERE FORMER EMPLOYER POSITION YEARS THERE. OTHER INCOME You need not list income from alimony, child support, or separate maintenance payments unless You want it considered in evaluating this credit application. TYPE OF OTHER INCOME MONTHLY AMOUNT TYPE OF OTHER INCOME MONTHLY AMOUNT.
4 $ $. NAME AND ADDRESS OF PAYER NAME AND ADDRESS OF PAYER. ASSETS AND DEPOSITS Attach a separate sheet if necessary. INTEREST INTEREST. TYPE BANK (OR OTHER) NAME & ADDRESS ACCOUNT NO. RATE APPROX. BAL. TYPE BANK (OR OTHER) NAME & ADDRESS ACCOUNT NO. RATE APPROX. BAL. CAR 1 - YR. - MAKE - MODEL APPROX. VALUE CAR 1 - YR. - MAKE - MODEL APPROX. VALUE. $ $. CAR 2 - YR. - MAKE - MODEL APPROX. VALUE CAR 2 - YR. - MAKE - MODEL APPROX. VALUE. $ $. HOMEOWNERS: PLEASE INDICATE NAME(S) ON DEED PURCHASE PRICE APPROX. VALUE HOMEOWNERS: PLEASE INDICATE NAME(S) ON DEED PURCHASE PRICE APPROX. VALUE. $ $ $ $. Copyright Oak Tree Business Systems, Inc., 1989-2012. All Rights Reserved. Page 1 of 2 OTBS 015 Web CENS (9/12). CREDIT INFORMATION Please check appropriate box below with corresponding code. Be sure to list all open accounts with or without a balance. A - If the credit is in Applicant' s name only. J - If account is joint credit (Applicant and Spouse/Co-Applicant) D - Debts to be paid off if loan is granted.
5 C - If the credit is in Your Spouse/Co-Applicant' s name only. N - If credit w as obtained under any other name. Attach separate sheet if necessary. PLEASE. LENDER (OR OTHER) NAME AND ADDRESS LIST ALL. CHECK ACCOUNT INTEREST ORIGINAL MONTHLY. OBLIGATIONS OBLIGATIONS INCLUDING CENSUS FEDERAL CREDIT UNION NUMBER BALANCE. A C J N D RATE AMOUNT PAYMENT. LOANS. MORTGAGE. RENT. SECOND. MORTGAGE. AUTO. MAKE. YEAR. AUTO. MAKE. YEAR. CREDIT CARD. APPROVAL OF THIS CREDIT APPLICATION MAY BE DELAYED IF ALL DEBTS ARE NOT LISTED. MEMBER STATES. THAT ALL OBLIGATIONS ARE LISTED. (Loan Of f icer Init ials)_____. Please answer the following questions. A C. If a yes answer is given, explain on an attached sheet. Yes No Yes No TOTALS $ $. 1. Have You filed a petition for bankruptcy in the last 10 years? Please Check: A = Applicant C = Spouse/Co-Applicant A C. Yes No Yes No 2. Have You ever had any auto, furniture or property repossessed? 6. Have You any obligations not listed?
6 3. Are You a co-maker or co-signer on any loan? 7. Do You have any past due bills? For Whom _____ Amount $_____. 8. Is any income You have listed likely to reduce in the next tw o years? 4. Have You ever had credit in any other name? What Name_____ 9. Indicate immigration status: 5. Have You any suits pending, judgments filed, alimony or support Applicant Citizen Permanent Resident Other_____. aw ards against You? Co-Applicant Citizen Permanent Resident Other_____. OPTIONAL CREDIT INSURANCE An appropriate application/disclosure w ill be furnished at the time Your credit is approved. Credit Lif e and/or Credit Disabilit y Insurance is not required t o obt ain credit under t his plan and, f or Credit Line Account s, w ill be included only if request ed immediat ely below by t he APPLICANT. The insurance rat es are show n below . The insurance rat es f or Credit Line Account s are show n below . For Credit Line Account s, t he insurance charge is calculat ed each mont h by mult iplying t he t ot al of t he remaining scheduled payment s of t he Account on t he last day of t hat mont h by t he rat e show n.
7 You must be under age 65, and, in addit ion, f or credit disabilit y insurance, You must be in act ive f ull t ime w ork f or w ages or prof it and physically present at w ork f or at least 30. hours f or each of t he 2 consecut ive w eeks prior t o each loan advance in order f or t he insurance t o t ake ef f ect f or t hat advance. Joint Lif e Coverage covers only a spouse w ho is a co-applicant . For Closed-End loans, t he t ot al insurance premium w ill be calculat ed and disclosed t o You separat ely. MONTHLY PREMIUM RATES PER $1000 OF TOTAL REMAINING SCHEDULED PAYMENTS - YOU MUST CHECK ONE OR MORE OF THE BOXES BELOW. CREDIT LIFE: Single Coverage - $_____ Yes No Joint Coverage - $_____ Yes No CREDIT DISABILITY (Primary Borrow er Only): Single Coverage - $_____ Yes No You are interested in Credit Disability Insurance single coverage You are interested in Credit Life Insurance single coverage joint coverage You are not interested in Credit Insurance If You applied f or Credit Insurance, You aut horize Us t o add t he required premiums t o Your Account , charge a f inance charge on t he premiums at t he rat e w hich applies t o Your Account , and f orw ard such premiums t o t he Insurance Company.
8 X. SIGNATURE OF APPLICANT _____. SIGNATURES. You w arrant t he t rut h of t he above inf ormat ion and You realize t hat it w ill be relied upon by Us in deciding w het her or not t o grant t he credit applied f or. You hereby aut horize Us, Our employees and agent s t o invest igat e and verif y any inf ormat ion provided t o Us by You. If t his applicat ion is f or any Feat ure Cat egory cont ained in Our Credit Line Account Program, You agree and underst and t hat if approved, You are cont ract ually liable according t o t he applicable t erms of t he Credit Line Account Agreement and Disclosure. You w ill receive a copy of t hat Agreement no lat er t han t he t ime of Your f irst advance and You promise t o pay all amount s charged t o Your Account according t o it s t erms. If t his is a joint applicat ion, You agree t hat such liabilit y is joint and several. LIEN IMPRESSMENT AND SET-OFF. You agree that We may impress and enforce a statutory lien upon Your Accounts w ith Us to the extent You ow e Us any money and We may enforce Our right to do so w ithout further notice to You.
9 We have the right to set-off any of Your money or property in Our possession against any amount You ow e Us. The right of set-off and Our impressed lien does not extend to any Keogh, IRA or similar tax deferred deposit You may have w ith Us. If Your Account is ow ned jointly, Our right of set-off and Our impressed lien extends to any amount ow ed to Us by any of the joint Ow ners. You aut horize Us t o accept Your f acsimile signat ure on t his applicat ion and agree t hat Your f acsimile signat ure w ill have t he same legal f orce and ef f ect as Your original signat ure. You assume any risk t hat may be associat ed w it h permit t ing Us t o accept Your f acsimile signat ure. If You are issued a debit Card or ATM card, You grant and consent to a lien on Your shares w ith Us (except IRA and Keogh accounts) and any dividends due or to become due to You from Us to the extent You ow e on any unpaid Redi-Cash Line-of-Credit and Premier Line-of-Credit balance created through the use of Your debit card or ATM card.
10 You hereby acknow ledge Your intent to apply for joint credit _____. Applicant' s Initials Co-Applicant' s Initials APPLICANT SIGNATURE DATE CO-APPLICANT SIGNATURE DATE. LOAN OFFICER CREDIT MANAGER OR OTHER. LOAN APPROVED YES NO REFERRED TO CC LOAN APPROVED YES NO. COUNTER OFFER WILL BE MADE. IF ACCEPTED, LOAN APPROVED. COUNTER OFFER WILL BE MADE. IF ACCEPTED, LOAN APPROVED. DESCRIBE COUNTER OFFER: SPECIFIC REASON(S) FOR REJECTION: LOAN OFFICER SIGNATURE DATE ADDITIONAL INFORMATION: CREDIT MANAGER OR OTHER DATE. ECOA NOTICE AND REASON FOR REJECTION OR UNACCEPTED COUNTER OFFER SENT OR DELIVERED ON (DATE) BY. Copyright Oak Tree Business Systems, Inc., 1989-2012. All Rights Reserved. Page 2 of 2 OTBS 015 Web CENS (9/12).