2023 Bright Light Loan - America's First Network Credit Union

2023 Bright Light Loan Application

Phone 860-291-0345
Fax 860-282-5819
Email: loans@afncu.com

Amount not to exceed $2,000.00.
All loans are for up to 18 months at 18.00% APR*

Check below to indicate the type of credit for which you are applying. Married Applicants may apply for a separate account.

INDIVIDUAL CREDIT: Complete Applicant section. Complete Co-Applicant, Spouse, (referred to as "Other") section: (1) about your spouse if you live in a community property state (AZ, CA, ID, LA, NM, NV, TX, WA, WI), or (2) if your spouse will use the Account. Please check box to indicate whom the information is about JOINT CREDIT: Each Applicant must individually complete the appropriate section below. If Co-Applicant is spouse of the Applicant, mark the Co-Applicant box. INDIVIDUAL ACCOUNT / LOAN JOINT ACCOUNT / LOAN

Amount Requested

Purpose/Collateral

APPLICANT INFORMATION

Applicant

Last Name

First Name

M.I.

Account Number

Social Security Number *

Membership status (check all that apply)

I have been a member of the credit union for at least 1 year I am not currently delinquent or overdrawn on my credit union account(s) I am currently employed and providing my income verification document(s) I authorize monthly payments from my AFNCU account

If any of the above boxes are not selected, please explain:

Driver's Licence Number/State

Date of Birth

Home Phone

Cell Phone

Business Phone/Ext.

Email Address *

Present Address *

Address Line 1 *

Address Line 2

City *

State *

Zip Code *

Ownership status *

Own Rent

Years at this residence *

Previous Address

Address Line 1

Address Line 2

City

State

Zip Code

Ownership Status

Own Rent

Years at this residence

Complete for Joint Credit, Secured Credit or if you Live in a Community Property State: *

Married Separated Unmarried (Single/Divorced/Widowed)

EMPLOYMENT INFORMATION

Employment Status

Full Time Part Time

Hours Per Week

Name and Address of Employer

Your Title/Grade

Start Date

Hours at Work

If Self Employed, Type of Business

If Employed Less Than Five Years, Complete Previous Employer Name and Address

Starting Date

Ending Date

INCOME INFORMATION

NOTICE: Alimony, child support, or separate maintenance income need not be revealed if you do not choose to have it considered.

Employment Income *

Per *

*

Net Gross

Other Income

Per

Net Gross

MILITARY: Is Duty Station Transfer Expected Within Next Year

Yes No

Where

Ending/Separation Date

References

(Please include Street, City, State and Zip)

Name and Address of Nearest Relative Not Living With You *

Relationship *

Phone *

Will a Co-Applicant / Spouse be included on this Application?

Yes No

OTHER

Co-Applicant Spouse

Last Name

First Name

M.I.

Driver's License Number / State

Date of Birth

Account Number

Social Security Number

Home Phone

Cell Phone

Business Phone/Ext.

Present Address

Address Line 1

Address Line 2

City

State

Zip Code

Ownership Status

Own Rent

Years at this address

Previous Address

Address Line 1

Address Line 2

City

State

Zip Code

Ownership Status

Own Rent

Years at this address

Complete for Joint Credit, Secured Credit or if you Live in a Community Property State: *

Married Separated Unmarried (Single/Divorced/Widowed)

EMPLOYMENT INFORMATION

Name and Address of Employer

Your Title/Grade

Start Date

Hours at Work

If Self Employed, Type of Business

If Employed Less Than Five Years, Complete Previous Employer Name and Address

Starting Date

Ending Date

MILITARY: Is Duty Station Transfer Expected Within Next Year

Yes No

Where?

Ending/Separation Date

INCOME INFORMATION

NOTICE: Alimony, child support, or separate maintenance income need not be revealed if you do not choose to have it considered.

Employment Income

Per

Net Gross

Other Income

Per

Net Gross

REFERENCES

(Please include Street, City, State and Zip)

Name and Address of Nearest Relative Not Living With You

Relationship

Phone

ASSETS - WHAT YOU OWN

Check box for Applicant/Other. List all assets and account number(s)

Applicant Information

Share Draft or Checking Amount

Name and Address of Depository

Share Draft of Checking Amount

Name and Address of Depository

Asset/Location

Market Value

Collateral on another loan?

Yes No

Other assets e.g., Auto, Boat, Stocks, Bonds, Cash, Household Goods, Real Estate, etc.

Asset/Location

Market Value

Collateral on another loan?

Yes No

Asset/Location

Market Value

Collateral on another loan?

Yes No

Asset/Location

Market Value

Collateral on another loan?

Yes No

Asset/Location

Market Value

Collateral on another loan?

Yes No

Asset/Location

Market Value

Collateral on another loan?

Yes No

Other Information (Co-Applicant, Spouse)

Share Draft of Checking Amount

Name and Address of Depository

Share Draft or Checking Amount

Name and Address of Depository

Asset/Location

Market Value

Collateral on another loan?

Yes No

Other assets e.g., Auto, Boat, Stocks, Bonds, Cash, Household Goods, Real Estate, etc.

Asset/Location

Market Value

Collateral on another loan?

Yes No

Asset/Location

Market Value

Collateral on another loan?

Yes No

Asset/Location

Market Value

Collateral on another loan?

Yes No

Asset/Loation

Market Value

Collateral on another loan?

Yes No

Asset/Location

Market Value

Collateral on another loan?

Yes No

DEBTS - WHAT YOU OWE

In addition to Rent/Mortgage list all other debts (for example, auto loans, credit cards, second mortgage, home assoc. dues, alimony, child support, child care, medical, utilities, auto insurance, IRS liabilities, etc.) Please use a separate line for each credit card and auto loan. Attach other sheets if necessary.

Applicant Information

Debt Type
Original Balance

Creditor Name and Address
Present Balance

Account Number
Monthly Payment

Debt Type
Original Balance

Creditor Name and Address
Present Balance

Account Number
Monthly Payment

Debt Type