Please complete all requested information and then submit form as indicated at bottom of page. You will be contacted regarding the status of your application.
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If you answer "yes", the credit union will disclose the cost to protect your loan. The credit insurance is voluntary and does not affect your loan approval. In order for your loan to be covered, you will need to sign a separate application that explains the terms and conditions.
Alimony, child support, or separate maintenance income need not be revealed if you do not wish to have it considered for repaying this obligation.
All the information in this application is true and complete. I understand the 18 U.S.C. 1014 makes it a federal crime to knowingly make any false statement on this application. You have my permission to check this application and you may retain this application even if the loan is not approved. I authorize you to obtain information from others about my credit, and to answer questions and requests from others seeking credit or experience information about me or my accounts with you.