Loan Application

Getting Started

Amount Requested *

Purpose of Loan *

Type of Credit Requested

IMPORTANT: Check the appropriate boxes and complete the applicable sections:

Type of Credit Requested*

Secured Unsecured Visa Credit Card

If Secured:

Year

Make

Model

VIN

Mileage

Options

Type of Credit Account*

Individual Credit (Relying solely on my income or assets) Individual Credit (Relying on my income or assets as well as income or assets from other sources) Joint Credit (We intend to apply for joint credit)

Personal Information

Primary Applicant

Name *

First

Last

Social Security Number *

Member Account Number

Birth Date

Home Phone

Cell Phone

Email Address *

Address

Address Line 1 *

Address Line 2

City *

State *

Zip Code *

Years at this address *

Rent/Mortgage Payment *

Type of Housing *

Own Outright Own Rent With Relatives Other

Mortgage Company/Landlord's Name

Mortgage Amount

Driver's License # or ID *

State

Marital Status

Married Unmarried

Joint Applicant

Type of Applicant

Co-Applicant Spouse Guarantor

Name

First

Last

Social Security Number

Birth Date

Home Phone

Cell Phone

Email Address

Address

Address Line 1

Address Line 2

City

State

Zip Code

Type of Housing

Own Outright Own Rent With Relatives Other

Mailing Address

Address Line 1

Address Line 2

City

State

Zip Code

Driver's License # or ID

State

Marital Status

Married Unmarried

Previous Address

If current address is less than two years.

Primary Applicant

Address 1

Years?

Address 2

Years?

Address 3

Years?

Joint Applicant

Address 1

Years?

Address 2

Years

Address 3

Years?

Primary Applicant

Employer

Work Phone

Employer's Address

Address Line 1 *

Address Line 2

City *

State *

Zip Code *

Position/Job Title *

Gross Monthly Income *

Start Date

Other Income per Month

Source

If employed in current position less than three years, complete the following

Previous Employer

Previous Employer's Address

Start Date

End Date

Joint Applicant

Employer

Work Phone

Employer's Address

Address Line 1

Address Line 2

City

State

Zip Code

Position/Job Title

If employed in current position less than three years, complete the following

Previous Employer

Previous Employer's Address

Start Date

End Date

References

Primary Applicant

Name and Address of Depository

Checking Account #

Name of relative not living with you *

Relationship *

Phone *

Relative's Address *

Name of a personal friend - not a relative *

Relationship *

Phone *

Friend's Address *

Joint Applicant

Name and Address of Depository

Checking Account #

Name of relative not living with you

Relationship

Phone

Relative's Address

Name of a personal friend - not a relative

Relationship

Phone

Friend's Address

These Questions Apply to both Applicant and Co-Applicant

Applicant- Have you any outstanding Judgements? *

Yes No

Co-Applicant - Have you any outstanding Judgements?

Yes No

Applicant - In the last 10 years, have you been declared bankrupt or filed a petition for Chapter 13? *

Yes No

Co-Applicant - In the last 10 years, have you been declared bankrupt or filed a petition for Chapter 13?

Yes No

Applicant - Have you had property foreclosed upon or given title or deed in lieu thereof, in the last 7 years? *

Yes No

Co-Applicant - Have you had property foreclosed upon or given title or deed in lieu thereof, in the last 7 years?

Yes No

Applicant - Are you party in a lawsuit? *

Yes No

Co-Applicant - Are you party in a lawsuit?

Yes No

Applicant - Are you other than a U.S. citizen or permanent resident alien? *

Yes No

Co-Applicant - Are you other than a U.S. citizen or permanent resident alien?

Yes No

Applicant - Is your income likely to reduce in the next two years? *

Yes No

Co-Applicant - Is your income likely to reduce in the next two years?

Yes No

Applicant - Are you a co-maker or co-signer on any loan? *

Yes No

Co-Applicant - Are you a co-maker or co-signer on any loan?

Yes No

For whom? (Name of others obligated on loan)

Applicant

Co-Applicant

To whom? (Name of creditor)

Applicant

Co-Applicant

Finishing Up

Preferred Contact Method *

Loan Promo Code

Comments

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 any misunderstandings or disappointments, any contract, promise, undertaking, or offer to forebear repayment of money or to make any other financial accommodation in connection with this loan of money or grant or extension of credit, or any amendment of, cancellation of, waiver of, or substitution for any 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, must be in writing to be effective. Notice to New York Residents: New York residents may contact the New York State Department of Financial Services to obtain a comparative listing of credit card rates, fees, and grace periods. New York State Department of Financial Services: 1-800-342-3736 or www.dfs.ny.gov. Notice 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 administers compliance with this law. Notice to Wisconsin Residents: (1) No provision of any marital property agreement, unilateral statement under Section 766.59, or court decree under Section 766.70 will adversely affect the rights of the Credit Union unless the Credit Union is furnished a copy of the agreement, statement or decree, or has actual knowledge of its terms, before the credit is granted or the account is opened. (2) Please sign if you are not applying for this account or loan with your spouse. The credit being applied for, if granted, will be incurred in the interest of the marriage or family of the undersigned.

Consensual Security Interest

You 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 secure your credit card account. Shares and deposits in an IRA or any other account that would lose special tax treatment under state or federal law if given as security are not subject to the security interest you have given in your shares and deposits. You may withdraw these other shares unless you are in default. When you are in default, you authorize us to apply the balance in these accounts to any amounts due. 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 balance.

By signing or otherwise authenticating below, you are affirmatively agreeing that you are aware that granting a security interest is a condition for the credit card and you intend to grant a security interest. You acknowledge and agree that your pledge does not apply during any periods when you are a covered borrower under the Military Lending Act. For clarity, you will not be deemed a covered borrower, and your pledge 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 borrower.

User Agreement

Everything that I have stated in this application is correct to the best of my knowledge. The Credit Union is authorized to check my credit, employment history, obtain a credit report and to answer questions about their credit experience with me. I understand that it may be a federal crime punishable by fine or imprisonment, or both, to knowingly make any false statements concerning any of the above facts as applicable under the provisions of the United States Criminal Code.

*

I have read and accept the terms

View the E-Sign Disclosure *

Yes

E-Sign Act Disclosure

E‐Sign Act Disclosure The Electronic Signatures in Global and National Commerce Act (ESIGN, Pub.L. 106-229, 14 Stat. 464, enacted June 30, 2000, 15 U.S.C. ch.96) is a United States federal law passed by the U.S. Congress to facilitate the use of electronic records and signatures in interstate and foreign commerce by ensuring the validity and legal effect of contracts entered into electronically. Although every state has at least one law pertaining to electronic signatures, it is the federal law that lays out the guidelines for interstate commerce. E-SIGN DISCLOSURE AND CONSENT This E-Sign Disclosure and Consent applies to all communications between the member and AMERICA’S FIRST NETWORK CREDIT UNION AND ITS DIVISIONS that are not otherwise governed by the terms and conditions of an electronic disclosure and consent. The words "we," "us," and "our" refer to America’s First Network Credit Union and its Divisions, with whom you have your account, and the words "you" and "your" mean you, the individual member(s) or entity identified on the Account(s). "Communication" means any member agreements or amendments thereto, disclosures, notices, responses to claims, transaction history, privacy policies and all other information related to the product or service, including but not limited to information that we are required by law to provide to you in writing. 1. Scope of Communications to Be Provided in Electronic Form. When you use a product or service to which this disclosure applies, you agree that we may provide you with any communication in electronic format, and that we may discontinue sending paper communications to you, unless and until you withdraw your consent as described below. Your consent to receive electronic communications and transactions includes, but is not limited to: • All legal and regulatory disclosures and communications associated with the product or service available through www.gpcu.org for your Account. • Notices or disclosures about a change in the terms of your Account or associated payment feature and responses to claims. • Privacy policies and notices. • Monthly (or other periodic) billing or account statements for your Account(s) or such other Communications that we may include from time to time as part of the enrollment in the eStatements program. • Your consent to receive electronic Communications does not automatically enroll you in eStatements. You must complete a separate enrollment to stop receiving by U.S. Mail paper account statements (and any other types of Communications we may include in e-Statements). 2. Method of Providing Communications to You in Electronic Form. All Communications that we provide to you in electronic form will be provided either (1) via e-mail, (2) by access to a web site that we will designate in an e-mail notice we send to you at the time the information is available, or (3) to the extent permissible by law, by access to a web site that we will generally designate in advance for such purpose. 3. How to Withdraw Consent. You may withdraw your consent to receive Communications in electronic form by contacting us at www.afncu.com , by calling 203-381-3800 or by contacting the nearest branch location. At our option, we may treat your provision of an invalid email address, or the subsequent malfunction of a previously valid email address, as a withdrawal of your consent to receive electronic Communications. We will not impose any fee to process the withdrawal of your consent to receive electronic Communications; however your access and use of our Online Services may be terminated. Any withdrawal of your consent to receive electronic Communications will be effective only after we have a reasonable period of time to process your withdrawal. 4. How to Update Your Records. It is your responsibility to provide us with true, accurate and complete e-mail address, contact, and other information related to this Disclosure and your Account(s), and to maintain and update promptly any changes in this information. You can update information (such as your e-mail address) through www.afncu.com , by calling us at 203-381-3800 or by contacting the nearest branch location. 5. Hardware and Software Requirements. In order to access, view, and retain electronic Communications that we make available to you, you must have: • an Internet browser that supports 128 bit encryption; • sufficient electronic storage capacity on your computer's hard drive or other data storage unit; • an e-mail account with an Internet service provider and e-mail software in order to participate in our electronic communications programs; • a personal computer (for PC's: Pentium 120 MHz or higher; for Macintosh, Power Mac 9500, Power PC 604 processor 120-MHz Base or higher), operating system and telecommunications connections to the Internet capable of receiving, accessing, displaying, and either printing or storing communications received from us in electronic form via a plain text-formatted e-mail or by access to our web site using one of the browsers specified above. • PDF document viewer software. 6. Requesting Paper Copies. We will not send you a paper copy of any communication, unless you request it or we otherwise deem it appropriate to do so. You can obtain a paper copy of an electronic communication by printing it yourself or by requesting that we mail you a paper copy, provided that such request is made within a reasonable time after we first provided the electronic communication to you. To request a paper copy, contact us by logging in to www.afncu.com and request a paper copy via email, or send a postal letter, or call us at 203-381-3800 or visit one of our branches in person. We may charge you a reasonable service charge for the delivery of paper copies of any communication provided to you electronically pursuant to this authorization. We reserve the right, but assume no obligation, to provide a paper (instead of electronic) copy of any communication that you have authorized us to provide electronically. 7. Communications in Writing. All communications in either electronic or paper format from us to you will be considered "in writing." You should print or download for your records a copy of this disclosure and any other communication that is important to you. 8. Signature. By accepting an account at America’s First Network Credit Union and/or one of its Divisions that requires e-Statements, e-notices, mobile alerts and notices, or by submitting an online application for services, you agree that an electronic facsimile of your signature or electronic agreement carries the full legal weight of a written signature. 9. Federal Law. You acknowledge and agree that your consent to electronic communications is being provided in connection with a transaction affecting interstate commerce that is subject to the federal Electronic Signatures in Global and National Commerce Act, and that you and we both intend that the Act apply to the fullest extent possible to validate our ability to conduct business with you by electronic means. 10. Termination/Changes. We reserve the right, in our sole discretion, to discontinue the provision of your electronic communications, or to terminate or change the terms and conditions on which we provide electronic communications. We will provide you with notice of any such termination or change as required by law. 11. Consent. By agreeing to the terms of an account requiring electronic signature, e-statements, or enotifications, or by checking "I have read, understand, and agree to the E-Sign Act." you hereby give your affirmative consent to provide electronic communications to you as described herein. You further agree that your computer satisfies the hardware and software requirements specified above and that you have provided us with a current e-mail address at which we may send electronic Communications to you

*

I have read, understand and agree to the E-Sign Act

Primary Signature *

Joint Signature

Date *

Getting Started

Type of Credit Requested

Personal Information

Primary Applicant

Joint Applicant

Previous Address

Primary Applicant

Joint Applicant

Primary Applicant

Joint Applicant

References

Primary Applicant

Joint Applicant

These Questions Apply to both Applicant and Co-Applicant

Finishing Up

State Law Notice(s)

Consensual Security Interest

User Agreement

E-Sign Act Disclosure

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