Please print and complete form, then take it to your ...

1 Please print and complete form , then take it to your nearest msfcu Loan Application Please note and initial all of the following points below: Member of msfcu for 6 months with an open and active account.* (*Active Account includes routine/consistent deposits equal to or greater than loan payment.)Member must be 21 years be in good standing with msfcu on all accounts (including joint accounts). msfcu credit cards must be outstanding balance on a Freedom Loan. Current paycheck stub must be submitted with this application (no more than 30 days old). (Also, Please include proof of any additional income, if applicable.)Accounts in courtesy pay/overdraft are not eligible.$20 Application fee must be available in account.

2 Loan amount will be determined using your financial capacity to repay this intend to pay this debt. Signature: _____ Date: _____ I have not filed : _____ Date: _____ It is not my intent to file bankruptcy in the near : _____ Date: _____ Amount Requested: Terms:Purpose of Loan: ($200 - $1,000) (1 6 months)$1, for 6 months - Monthly Payment estimated at $ $ for 6 months - Monthly Payment estimated at $ Number: 3/201 MAIN BRANCHGRENADA BRANCHOXFORD BRANCH2500 North State Street960 J K Avent Drive1101 Jackson Ave. WestJackson, MS 39216 Grenada, MS 38901 Oxford, MS 38655 Phone: (800) 643-1567 Phone: (662) 227-7153 Phone: (662) 236-9099 CUNA Mutual Group 2016 All Rights Reserved02301231-AXX00-P-1-083017 (AXX001-E)APPLICATIONT here are costs associated with the use of a credit card.

3 Information about costs, rates and fees may be contained in disclosures provided with thisapplication or by calling us toll-free or collect ator writing to us at the address stated on this below to indicate the type of credit for which you are applying. Married Applicants may apply for a separate Credit:You must complete the Applicant section about yourself and the Other section about your spouse live in or the property pledged as collateral is located in a community property state (AK, AZ, CA, ID, LA, NM, NV, TX, WA, WI) spouse will use the account, are relying on your spouse's income as a basis for repayment. If you are relying on income from alimony, child support, or separatemaintenance, complete theOthersection to the extent possible about the person on whose payments you are Credit:Each Applicant mustindividuallycomplete appropriate section below.

4 If Co-Borrower is spouse of the Applicant, mark the Account/Loan:IndividualJoint(Including ATM/Debit card access to the account if available)Credit Card Account: Individual JointIf this is an application for joint credit, Applicant and Co-Applicant each agree and acknowledge the intent to apply for joint credit (sign below):ApplicantDateX(Seal)Co-ApplicantD ateX(Seal)Amount Requested $Purpose/Collateral: Credit Limit Requested $If Authorized User, Name:GuarantorsCompleteOTHER section (Last - First - Initial)NAME (Last - First - Initial)ACCOUNT NUMBERSOCIAL SECURITY NUMBERACCOUNT NUMBERSOCIAL SECURITY NUMBERBIRTH DATEEMAIL ADDRESSBIRTH DATEEMAIL ADDRESSHOME PHONECELL PHONEBUSINESS PHONECELL PHONEBUSINESS S LICENSE NUMBER/STATEAGES OF DEPENDENTSDRIVER S LICENSE NUMBER/STATEAGES OF DEPENDENTSPRESENT ADDRESS (Street City State Zip)OWNRENTPRESENT ADDRESS (Street City State Zip)OWNRENTLENGTH AT RESIDENCELENGTH AT RESIDENCEPREVIOUS ADDRESS (Street City State Zip)OWNRENTPREVIOUS ADDRESS (Street City State Zip)

5 OWNRENTLENGTH AT RESIDENCELENGTH AT RESIDENCEMORTGAGE/RENT OWED TOMORTGAGE/RENT OWED TOMORTGAGE BALANCE$MONTHLY PAYMENT$INTEREST RATE%MORTGAGE BALANCE$MONTHLY PAYMENT$INTEREST RATE% complete FOR JOINT CREDIT, SECURED CREDIT OR IF YOU LIVE IN A COMMUNITYPROPERTY STATE: complete FOR JOINT CREDIT, SECURED CREDIT OR IF YOU LIVE IN A COMMUNITYPROPERTY STATE:MARRIEDSEPARATEDUNMARRIED (Single - Divorced - Widowed)MARRIEDSEPARATEDUNMARRIED (Single - Divorced - Widowed)EMPLOYMENT/INCOMESTART DATEEMPLOYMENT/INCOMESTART DATEEMPLOYMENT STATUSFULL TIMEPART TIMEEMPLOYMENT STATUSFULL TIMEPART TIMENAME AND ADDRESS OF EMPLOYERNAME AND ADDRESS OF EMPLOYERNOTICE: ALIMONY, CHILD SUPPORT, OR SEPARATE MAINTENANCE INCOME NEED NOTBE REVEALED IF YOU DO NOT CHOOSE TO HAVE IT : ALIMONY, CHILD SUPPORT, OR SEPARATE MAINTENANCE INCOME NEED NOTBE REVEALED IF YOU DO NOT CHOOSE TO HAVE IT INCOME$PEROTHER INCOME$PEREMPLOYMENT INCOME$PEROTHER INCOME$PERTITLE/GRADESOURCETITLE/GRADESO URCEPREVIOUS EMPLOYER NAME AND ADDRESS IF EMPLOYED LESS THAN FIVE YEARSPREVIOUS EMPLOYER NAME AND ADDRESS IF EMPLOYED LESS THAN FIVE YEARS(800) 643-156702301231-AXX00-P-1-083017 (AXX001-E)STARTING DATEENDING DATESTARTING DATEENDING DATEMILITARY: IS DUTY STATION TRANSFER EXPECTED DURING NEXT YEAR?

6 YES NOMILITARY: IS DUTY STATION TRANSFER EXPECTED DURING NEXT YEAR?YESNOWHEREENDING/SEPARATION DATEWHEREENDING/SEPARATION DATEREFERENCEREFERENCENAME AND ADDRESS OF NEAREST RELATIVE NOT LIVING WITH YOUNAME AND ADDRESS OF NEAREST RELATIVE NOT LIVING WITH YOURELATIONSHIPHOME PHONERELATIONSHIPHOME PHONEWHAT YOU OWEDEBTCREDITOR NAME OTHER THAN THIS CREDIT UNION(Attach additional sheet(s) if necessary)INTEREST RATEPRESENT BALANCEMONTHLY PAYMENTOWED BY APPLICANT OTHER RENT%$$ FIRST MORTGAGE(Incl. Tax & Ins.)%$$%$$%$$%$$%$$%$$%$$%$$%$$%$$%$$LI ST ANY NAMES UNDER WHICH your CREDIT REFERENCESAND CREDIT HISTORY CAN BE CHECKED:TOTALS$$WHAT YOU OWNASSET DESCRIPTIONLIST LOCATION OF PROPERTY OR FINANCIAL INSTITUTIONMARKET VALUEPLEDGED AS COLLATERALFOR ANOTHER LOANOWNED BYAPPLICANTOTHER$YESNO$YESNO$YESNO$YESNO $YESNO$YESNO$YESNOOTHER INFORMATION ABOUT YOUIF YOU ANSWER YES (BY CHECKING THE BOX) TO ANY QUESTION OTHER THAN #1,EXPLAIN ON AN ATTACHED YOU A CITIZEN OR PERMANENT RESIDENT ALIEN?

7 YOU CURRENTLY HAVE ANY OUTSTANDING JUDGMENTS OR HAVE YOU EVER FILED FOR BANKRUPTCY, HAD A DEBT ADJUSTMENTPLAN CONFIRMED UNDER CHAPTER 13, HAD PROPERTY FORECLOSED UPON OR REPOSSESSED IN THE LAST 7 YEARS, OR BEEN A PARTYIN A LAWSUIT? your INCOME LIKELY TO DECLINE IN THE NEXT TWO YEARS? YOU A CO-MAKER, CO-SIGNER OR GUARANTOR ON ANY LOAN NOT LISTED ABOVE?FOR WHOM (Name of Others Obligated on Loan):TO WHOM (Name of Creditor):02301231-AXX00-P-1-083017 (AXX001-E)STATE LAW NOTICE(S)Notice to Nebraska Residents: A credit agreement must be in writing to be enforceable under Nebraska law. To protect you and us from anymisunderstandings or disappointments, any contract, promise, undertaking, or offer to forebear repayment of money or to make any other financialaccommodation in connection with this loan of money or grant or extension of credit, or any amendment of, cancellation of, waiver of, or substitution forany or all of the terms or provisions of any instrument or document executed in connection with this loan of money or grant or extension of credit, mustbe in writing to be to New York Residents: New York residents may contact the New York State Department of Financial Services to obtain a comparative listingof credit card rates, fees, and grace periods.

8 New York State Department of Financial Services: 1-800-342-3736 or to Ohio Residents: The Ohio laws against discrimination require that all creditors make credit equally available to all creditworthy customers,and that credit reporting agencies maintain separate credit histories on each individual upon request. The Ohio Civil Rights Commission administerscompliance with this to Wisconsin Residents: (1) No provision of any marital property agreement, unilateral statement under Section , or court decree underSection will adversely affect the rights of the Credit Union unless the Credit Union is furnished a copy of the agreement, statement or decree, orhas actual knowledge of its terms, before the credit is granted or the account is opened.

9 (2) Please sign if you are not applying for this account or loanwith your spouse. The credit being applied for, if granted, will be incurred in the interest of the marriage or family of the for Wisconsin Residents OnlyDateX(Seal)CONSENSUAL SECURITY INTERESTYou grant us a security interest in all individual and joint share and/or deposit accounts you have with us now and in the future to secureyour credit card account. Shares and deposits in an IRA or any other account that would lose special tax treatment under state or federal lawif given as security are not subject to the security interest you have given in your shares and deposits. You may withdraw these other sharesunless you are in default. When you are in default, you authorize us to apply the balance in these accounts to any amounts due.

10 For example,if you have an unpaid credit card balance, you agree we may use funds in your account(s) to pay any or all of the unpaid signing or otherwise authenticating below, you are affirmatively agreeing that you are aware that granting a security interest is a conditionfor the credit card and you intend to grant a security interest. You acknowledge and agree that your pledge does not apply during anyperiods when you are a covered borrower under the Military Lending Act. For clarity, you will not be deemed a covered borrower, and yourpledge will apply, if: (i) you become obligated on a credit transaction or establish an account for credit when you are not a covered borrower;or (ii) you cease to be a covered Interest Acknowledgement and AgreementDateX(Seal)Security Interest Acknowledgement and AgreementDateX(Seal)SIGNATURESBy signing or otherwise authenticating promise that everything you have stated in this application is correct to the best of your knowledge, and that the above information is acomplete listing of what you owe.